Lung Microbiome Challenges Traditional Ventilator-Associated Pneumonia Paradigms
This review reframes ventilator-associated pneumonia through the lens of lung microbial ecology, arguing that recognition of the pulmonary microbiome and virome demands integration of molecular diagnostic techniques beyond conventional culture. The authors highlight opportunities for microbiome-informed diagnostics and immunomodulatory therapies, including corticosteroids and probiotics, in VAP management.
The original study
Reconsidering ventilator-associated pneumonia from a new dimension of the lung microbiome.
- Authors
- Fernández-Barat L, López-Aladid R, Torres A
- Journal
- EBioMedicine
- Type
- Journal Article, Review
- PMID
- 32950001
Original abstract
Complex microbial communities that reside in the lungs, skin and gut are now appreciated for their role in maintaining organ, tissue and immune homoeostasis. As lungs are currently seen as an ecosystem, the shift in paradigm calls for the consideration of new algorithms related to lung ecology in pulmonology. Evidence of lung microbiota does not solely challenge the traditional physiopathology of ventilator-associated pneumonia (VAP); indeed, it also reinforces the need to include molecular techniques in VAP diagnosis and accelerate the use of immunomodulatory drugs, including corticosteroids, and other supplements such as probiotics for VAP prevention and/or treatment. With that stated, both microbiome and virome, including phageome, can lead to new opportunities in further understanding the relationship between health and dysbiosis in VAP. Previous knowledge may be, however, reconsidered at a microbiome scale.