Pathogens of Aspiration Pneumonia Based on a Novel Approach: Are the Causative Bacteria Different from Those of CAP or HAP? View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2020-06-18

AUTHORS

Toshinori Kawanami , Kazuhiro Yatera

ABSTRACT

The causative bacteria of aspiration pneumonia have greatly changed in the last five decades. Anaerobes were believed to be the main causative bacteria of aspiration pneumonia since the 1970s, accounting for 80–90%, and anti-anaerobe agents were recommended for treating aspiration pneumonia. However, the frequency of detection of anaerobes as causative pathogens in patients with aspiration pneumonia has significantly declined since the 2000s. Based on the concept that aspiration pneumonia is generally caused by an invasion of oral bacteria into the lower respiratory tract, it is important to precisely detect and evaluate oral bacteria including anaerobes as causative bacteria in patients with aspiration pneumonia. However, it is usually difficult to evaluate whether oral bacteria are pathogenic or not in the lower respiratory tract infection when culture method using sputum that pass through the oral cavity from the lower respiratory tract is positive for oral bacteria.Recent development of molecular biological methods, such as targeted polymerase chain reaction, that are independent from culture has made it possible to overcome the above-mentioned difficulties by comprehensively evaluating bacterial flora rather than detecting specific bacterial species. In molecular analysis using 16S ribosomal RNA gene of bronchoalveolar lavage fluid (BALF) in pneumonia patients, assumed causative pathogens of aspiration pneumonia were mainly oral streptococci, and anaerobes were not the main causative bacteria. Even in community-onset pneumonia, oral streptococci were mainly detected in patients with poor functional status. In hospital-acquired pneumonia, Corynebacterium spp. were frequently detected from the lower respiratory tract, although oral streptococci were mostly involved. The results of culture-independent molecular methods in BALF may indicate that so-called potentially drug-resistant pathogens such as Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus tend to be overestimated by culture methods, and detecting anaerobes may be strongly influenced by poor oral hygiene status. These changes in bacteriology are thought to occur due to differences in clinical backgrounds, sanitary situation including oral hygiene and care, and analytic methods, and continuous evaluation and monitoring are necessary to elucidate the relationship between detected pathogens and the clinical factors in patients with aspiration pneumonia. More... »

PAGES

63-74

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-981-15-4506-1_6

DOI

http://dx.doi.org/10.1007/978-981-15-4506-1_6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1128552627


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