• Mary Lou Sole, Shibu Yooseph, Steven Talbert, Bassam Abomoelak, Chirajyoti Deb, Kimberly Paige Rathbun, Daleen Penoyer, Aurea Middleton, and Devendra Mehta.
• Mary Lou Sole is dean, professor, and Orlando Health Endowed Chair in Nursing, College of Nursing, University of Central Florida, Orlando, Florida.
• Am. J. Crit. Care. 2021 Mar 1; 30 (2): 128-132.

BackgroundInterest in the pulmonary microbiome is growing, particularly in patients undergoing mechanical ventilation.ObjectivesTo explore the pulmonary microbiome over time in patients undergoing prolonged mechanical ventilation and to evaluate the effect of an oral suctioning intervention on the microbiome.MethodsThis descriptive subanalysis from a clinical trial involved a random sample of 16 participants (7 intervention, 9 control) who received mechanical ventilation for at least 5 days. Five paired oral and tracheal specimens were evaluated for each participant over time. Bacterial DNA from the paired specimens was evaluated using 16S rRNA gene sequencing. Bacterial taxonomy composition, α-diversity (Shannon index), and β-diversity (Morisita-Horn index) were calculated and compared within and between participants.ResultsParticipants were predominantly male (69%) and White (63%), with a mean age of 58 years, and underwent mechanical ventilation for a mean of 9.36 days. Abundant bacterial taxa included Prevotella, Staphylococcus, Streptococcus, Stenotrophomonas, and Veillonella. Mean tracheal α-diversity decreased over time for the total group (P = .002) and the control group (P = .02). β-Diversity was lower (P = .04) in the control group (1.905) than in the intervention group (2.607).ConclusionsProlonged mechanical ventilation was associated with changes in the pulmonary microbiome, with the control group having less diversity. The oral suctioning intervention may have reduced oral-tracheal bacterial transmission.©2021 American Association of Critical-Care Nurses.

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