Profiling tracheal aspirate microbiome samples in children with and without prior lung disease

Children who require airway intubation are almost always treated with empiric antibiotics, pending clinical microbiology results. Positive pathogen results are near inevitable, due to the frequent presence of potential opportunistic pathogens, whether they are causing disease or not. This pattern leads to potential antibiotic over-prescribing, to the detriment of both patients who do not require antibiotics, and to antimicrobial stewardship goals. To assess our hypothesis that opportunistic pathogens are more common in children with prior lung disease, we prospectively profiled tracheal aspirate (TA) microbiome samples in children with and without prior lung disease.

需要气道插管的儿童，几乎均会在临床微生物学检测结果出炉前接受经验性抗菌药物治疗。由于常存在潜在机会致病菌（无论其是否引发疾病），病原学检测呈阳性的结果几乎不可避免。此种诊疗模式可能导致抗菌药物过度处方，既损害了无需抗菌药物治疗的患儿的健康，也不利于抗菌药物管理（antimicrobial stewardship）的目标达成。为验证"既往存在肺部疾病的儿童体内机会致病菌检出率更高"这一假说，我们对既往伴或不伴肺部疾病的儿童的气管抽吸物（tracheal aspirate, TA）微生物组样本进行了前瞻性谱型分析。