title: Microbial profiling of dental plaque from mechanically ventilated patients.
abstract: Micro-organisms isolated from the oral cavity may translocate to the lower airways during mechanical ventilation (MV) leading to ventilator-associated pneumonia (VAP). Changes within the dental plaque microbiome during MV have been documented previously, primarily using culture-based techniques. The aim of this study was to use community profiling by high throughput sequencing to comprehensively analyse suggested microbial changes within dental plaque during MV. Bacterial 16S rDNA gene sequences were obtained from 38 samples of dental plaque sampled from 13 mechanically ventilated patients and sequenced using the Illumina platform. Sequences were processed using Mothur, applying a 97% gene similarity cut-off for bacterial species level identifications. A significant 'microbial shift' occurred in the microbial community of dental plaque during MV for nine out of 13 patients. Following extubation, or removal of the endotracheal tube that facilitates ventilation, sampling revealed a decrease in the relative abundance of potential respiratory pathogens and a compositional change towards a more predominantly (in terms of abundance) oral microbiota including Prevotella spp., and streptococci. The results highlight the need to better understand microbial shifts in the oral microbiome in the development of strategies to reduce VAP, and may have implications for the development of other forms of pneumonia such as community-acquired infection.
authors.affiliation: Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK.
authors.forename: Kirsty M
authors.initials: KM
authors.lastname: Sands
authors.affiliation: Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Twigg
authors.affiliation: Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK.
authors.forename: Michael A O
authors.initials: MAO
authors.lastname: Lewis
authors.affiliation: Adult Critical Care, University Hospital of Wales, Heath Park, Cardiff, UK.
authors.forename: Matt P
authors.initials: MP
authors.lastname: Wise
authors.affiliation: School of Biosciences, Main Building, Park Place, Cardiff University, Cardiff, Wales, UK.|Centre for Digestive and Gut Health, Imperial College London, London, UK.
authors.forename: Julian R
authors.initials: JR
authors.lastname: Marchesi
authors.affiliation: School of Biosciences, Main Building, Park Place, Cardiff University, Cardiff, Wales, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: Smith
authors.affiliation: Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Wilson
authors.affiliation: Oral and Biomedical Sciences, School of Dentistry, Cardiff University, UK.
authors.forename: David W
authors.initials: DW
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D001419:Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003773:Dental Plaque / Q000150:complications / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D053717:Pneumonia, Ventilator-Associated / Q000209:etiology / Q000382:microbiology*; D012121:Respiration, Artificial / Q000009:adverse effects; D055815:Young Adult