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- W4254964549 abstract "Background : Ventilator Associated Pneumonia (VAP) continues to be one of the most significant causes of mortality and morbidity in pediatric ICUs. The infection is mediated by pathogenic biofilms on endotracheal tubes (ETT). These biofilms exhibit significant antimicrobial resistance and unique mechanisms of pathogenesis which are poorly understood and extremely difficult to treat. Methods : ETTs from VAP patients and uninfected controls were subjected to mult-point analyses. The etiological agents were isolated and biofilms cultured on ETT in vitro. These biofilms and VAP-ETT were analyzed by scanning electron microscopy, antibiotic sensitivity assays and expression of pathogenic protease(s). The pathogenecity of the biofilms were examined on human lung epithelial cells lines in vitro on the A549 cell-line model. Results : Biofilms of potent VAP pathogens like Pseudomonas aeruginosa form sophisticated, highly structured communities on regular ETT under typical ventilator conditions. These biofilms exhibit >100 fold resistance against conventional antibiotics than their planktonic counterparts. Mature ETT biofilms lead to turbulent flow in the ventilator with risk for occlusion, release quorum regulated proteases and other pathogenic factors that lead to profound toxicity on human lung epithelial cells. Conclusion : Bacterial biofilms present a potent mechanisms of pathogenesis in VAP that are little explored and important to treat pediatric VAP. Anti-biofilm strategies in VAP management need to be explored." @default.
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- W4254964549 date "2018-01-01" @default.
- W4254964549 modified "2023-09-27" @default.
- W4254964549 title "Endotracheal Tube (ETT) biofilms, drug resistance and pathogenesis of ventilator associated pneumonia: Observations from tertiary care Pediatric Intensive Care Unit (PICU)" @default.
- W4254964549 doi "https://doi.org/10.21304/2018.0501.00299" @default.
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