Please use this identifier to cite or link to this item: https://scholarbank.nus.edu.sg/handle/10635/129053
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dc.titleEndogenous source of bacteria in tracheal tube and proximal ventilator breathing system in intensive care patients
dc.contributor.authorInglis, T.J.J.
dc.contributor.authorLim, E.-W.
dc.contributor.authorLee, G.S.H.
dc.contributor.authorCheong, K.-F.
dc.contributor.authorNg, K.-S.
dc.date.accessioned2016-10-26T11:01:26Z
dc.date.available2016-10-26T11:01:26Z
dc.date.issued1998-01
dc.identifier.citationInglis, T.J.J.,Lim, E.-W.,Lee, G.S.H.,Cheong, K.-F.,Ng, K.-S. (1998-01). Endogenous source of bacteria in tracheal tube and proximal ventilator breathing system in intensive care patients. British Journal of Anaesthesia 80 (1) : 41-45. ScholarBank@NUS Repository.
dc.identifier.issn00070912
dc.identifier.urihttp://scholarbank.nus.edu.sg/handle/10635/129053
dc.description.abstractAlthough bacteria from both the ventilator breathing system and the gastrointestinal tract have been implicated in the pathogenesis of ventilator-associated pneumonia, an endogenous source of bacteria in the proximal respiratory breathing system has yet to be demonstrated conclusively. We investigated a potential route of bacterial colonization from the stomach contents to the efferent limb of the ventilator breathing system by bacterial culture of daily specimens from six sites in 20 surgical intensive care patients. Gram-negative bacilli were isolated in a progressively increasing proportion of samples at successive sampling points, consistent with an endogenous-to-external route of spread (patients, chi-square = 14.12, P < 0.02; samples, chi-square = 106.15, P < 0.001). Identical strains of gram-negative bacilli, confirmed by REPS typing, were found at two or more sites in seven patients. In all seven, gram-negative bacilli were first isolated from a site in the patient. In none of the 20 patients was there evidence of a sequence of colonization from the ventilator tubing or Y-piece connector towards the patient. Probable colonization sequences plotted from the time of first isolation supported the proposed sequence in six patients, and in five began with the stomach contents. Isolation sequences contrary to the proposed direction of colonization involved four bacterial species and two patients, and did not extend beyond two sample sites. These findings imply that the retrograde route of bacterial colonization of the ventilated lung extends into the proximal respiratory breathing system and may help to identify additional targets for preventive intervention.
dc.sourceScopus
dc.subjectEquipment, breathing systems
dc.subjectInfection, bacterial
dc.subjectInfection, breathing systems
dc.subjectInfection, nosocomial
dc.subjectIntensive care
dc.subjectVentilation, mechanical
dc.typeArticle
dc.contributor.departmentANAESTHESIA
dc.description.sourcetitleBritish Journal of Anaesthesia
dc.description.volume80
dc.description.issue1
dc.description.page41-45
dc.description.codenBJANA
dc.identifier.isiutNOT_IN_WOS
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