Patterns and density of early tracheal colonization in intensive care unit patients

Lakshmi Durairaj; Zeinab Mohamad; Janice L Launspach; Alix Ashare; James Y Choi; Srinivasan Rajagopal; Gary V Doern; Joseph Zabner

doi:10.1016/j.jcrc.2008.10.009

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Patterns and density of early tracheal colonization in intensive care unit patients

Journal article

Peer reviewed

Patterns and density of early tracheal colonization in intensive care unit patients

Lakshmi Durairaj, Zeinab Mohamad, Janice L Launspach, Alix Ashare, James Y Choi, Srinivasan Rajagopal, Gary V Doern and Joseph Zabner

Journal of critical care, Vol.24(1), pp.114-121

2009

DOI: 10.1016/j.jcrc.2008.10.009

PMCID: PMC2762407

PMID: 19272547

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https://www.ncbi.nlm.nih.gov/pmc/articles/2762407View

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Abstract

The study aimed to describe the patterns and density of early tracheal colonization among intubated patients and to correlate colonization status with levels of antimicrobial peptides and inflammatory cytokines. The was a prospective cohort study. The study was conducted in medical and cardiovascular intensive care units of a tertiary referral hospital. Seventy-four adult patients admitted between March 2003 and May 2006 were recruited for the study. Tracheal aspirates were collected daily for the first 4 days of intubation using standardized, sterile technique and sent for quantitative culture and cytokines, lactoferrin and lysozyme measurements. The mean acute physiology and chronic health evaluation (APACHE II) score in this cohort was 24 ± 7. Proportion of subjects colonized by any microorganism increased over the first 4 days of intubation (47%, 60%, 70%, 70%, P = .08), but density of colonization for bacteria or yeast did not change significantly. No known risk factors predicted tracheal colonization on day 1 of intubation. Several patterns of colonization were observed (persistent, transient, new colonization, and clearance of initial colonization).The most common organisms cultured were Candida albicans and coagulase-negative Staphylococcus. Levels of cytokines, lactoferrin, or lysozyme did not change over time and were not correlated with tracheal colonization status. Four subjects (6%) had ventilator-associated pneumonia. The density of tracheal colonization did not change significantly over the first 4 days of intubation in medical intensive care unit patients. There was no correlation between tracheal colonization and the levels of antimicrobial peptides or cytokines. Several different patterns of colonization may have to be considered while planning interventions to reduce airway colonization.

Quantitative culture

Lactoferrin

Tracheal aspirate

Intensive care unit

Lysozyme

Cytokine

Details

Title: Subtitle: Patterns and density of early tracheal colonization in intensive care unit patients
Creators: Lakshmi Durairaj - Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Zeinab Mohamad - Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Janice L Launspach - Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Alix Ashare - Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
James Y Choi - Department of Anesthesiology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Srinivasan Rajagopal - Department of Anesthesiology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Gary V Doern - Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Joseph Zabner - Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Resource Type: Journal article
Publication Details: Journal of critical care, Vol.24(1), pp.114-121
DOI: 10.1016/j.jcrc.2008.10.009
PMID: 19272547
PMCID: PMC2762407
NLM abbreviation: J Crit Care
ISSN: 0883-9441
eISSN: 1557-8615
Publisher: Elsevier Inc
Language: English
Date published: 2009
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Epidemiology; Pathology; Anesthesia; Medicine Administration; Internal Medicine
Record Identifier: 9984006478802771

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