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Potential Pathogens Are Predominant in the Oral Microbiome of Pediatric Intensive Care Unit Patients

Scaggs Huang, Felicia

Abstract Details

2019, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Background: Healthcare-associated infections (HAIs) are a significant cause of morbidity and mortality in critically ill children. Previous research demonstrates that commensal gut anaerobes provide host resistance against colonization and infection with pathogens, but data is lacking from other potential reservoirs such as the mouth. Methods: A longitudinal cross-sectional study was conducted in PICU patients (0-18 years) receiving antibiotics who were recruited within 72 hours of admission at a quaternary pediatric center 2017-2018. Healthy children without antibiotic exposures in the prior 30 days were enrolled from clinics as age-matched outpatient controls. Metagenomic shotgun sequencing of oral swabs was performed for comparisons of community composition and Shannon diversity between groups using Wilcoxon rank sum and principal coordinate analyses. Results: Comparison of oral samples found a difference in community composition and Shannon diversity of the oral microbiomes with increased abundance of fecal anaerobes and potential pathogens in PICU patients (n=57) compared to age matched controls (n=55). There was no difference in oral microbiome composition or diversity when comparing underlying comorbidities, intubation status, or antibiotic intensity between PICU subgroups. Conclusions: The oral microbiome is impacted by critical illness and hospitalization in the context of antibiotic administration. PICU patients compared to healthy controls demonstrated loss of normal oral flora replaced with increased fecal anaerobes and common HAI organisms, suggesting the mouth is an important reservoir of pathogens. Future studies using metagenomic screening may better identify children at-risk and modify clinical interventions to allow for prevention of HAI in the PICU.
Patrick Ryan, Ph.D. (Committee Chair)
David Haslam, M.D. (Committee Member)
Nicholas Ollberding, Ph.D. (Committee Member)
37 p.

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Citations

  • Scaggs Huang, F. (2019). Potential Pathogens Are Predominant in the Oral Microbiome of Pediatric Intensive Care Unit Patients [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1563272800210079

    APA Style (7th edition)

  • Scaggs Huang, Felicia. Potential Pathogens Are Predominant in the Oral Microbiome of Pediatric Intensive Care Unit Patients. 2019. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1563272800210079.

    MLA Style (8th edition)

  • Scaggs Huang, Felicia. "Potential Pathogens Are Predominant in the Oral Microbiome of Pediatric Intensive Care Unit Patients." Master's thesis, University of Cincinnati, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1563272800210079

    Chicago Manual of Style (17th edition)