Implications of the presence of yeasts in tracheobronchial secretions of critically ill intubated patients

Authors

  • Elenice Gomes Ferreira Graduate Programme in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil; Department of Physiotherapy UniCesumar, Maringá, PR, Brazil
  • Fabrício Yatsuda Department of Physiotherapy UniCesumar, Maringá, PR, Brazil; PIC/UniCesumar/ICETI (Instituto Cesumar de Ciência, Tecnologia e Inovação)
  • Marcio Pini Department of Physiotherapy UniCesumar, Maringá, PR, Brazil; PIC/UniCesumar/ICETI (Instituto Cesumar de Ciência, Tecnologia e Inovação)
  • Isabele Carrilho Jarros Graduate Programme in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
  • Flávia Franco Veiga Graduate Programme in Health Sciences, Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil
  • Admilton Gonçalves de Oliveira Laboratory of Electron Microscopy and Microanalysis, Universidade Estadual de Londrina, Londrina, PR, Brazil
  • Melyssa Negri Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringa, Avenida Colombo 5790, 87020-900 Maringá, PR, Brazil
  • Terezinha Inez Estivalet Svidzinski Division of Medical Mycology, Teaching and Research Laboratory in Clinical Analyses, Department of Clinical Analysis of State University of Maringa, Avenida Colombo 5790, 87020-900 Maringá, PR, Brazil, Telephone: +554430114810; E-mail: terezinha.svidzinski@gmail.com

DOI:

https://doi.org/10.17179/excli2019-1631

Keywords:

intubation, intratracheal, ventilators, mechanical, biofilms, Candida

Abstract

The presence of some microorganisms in the respiratory tract is a known risk factor for the infection of air passages; however, it is not clear whether this holds true for Candida spp. Thus, our objective was to determine the frequency of yeast colonization in the tracheobronchial secretions of critically ill intubated patients and to assess the presence of these yeasts in the infra-cuff region of the endotracheal tube (ET). Patients aged 18 years or older who had been using an endotracheal tube for 48 hours were recruited. Tracheal secretions were collected; after extubation, the ETs were cut into two fragments in the infra-cuff region. One of these fragments was placed in a solution containing antibiotics and sent to the lab for culture and identification of yeasts. The remaining fragment was fixed and subjected to scanning electron microscopy (SEM). In total, 20 patients with an average age of 73.3 years (± 13.1) participated in this study. These patients remained under endotracheal intubation and invasive mechanical ventilation for an average of 6.4 (± 1.8) and 13.5 days (± 15), respectively. Of these patients, 45 % showed respiratory tract colonization by yeasts of the Candida genus, with C. albicans being the most frequently isolated species (66.7 %). Moreover, in almost 90 % of these patients, blastoconidia of the same yeast were found in the infra-cuff portion of the ET, as evidenced by SEM, strongly fixed on the ET surface. Yeasts isolated from both the infra-cuff region and the tracheobronchial secretions were susceptible to amphotericin B and fluconazole. In conclusion, our results show that the frequency of colonization by yeasts of the Candida genus in the tracheobronchial secretions of intubated patients within 48 hours is high, and that these species can also be found as a biofilm on the ET surface.

Published

2019-09-09

How to Cite

Ferreira, E. G., Yatsuda, F., Pini, M., Jarros, I. C., Veiga, F. F., de Oliveira, A. G., … Svidzinski, T. I. E. (2019). Implications of the presence of yeasts in tracheobronchial secretions of critically ill intubated patients. EXCLI Journal, 18, 801–811. https://doi.org/10.17179/excli2019-1631

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Original articles

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