Bacterial pneumonia is a major cause of mechanical ventilation in intensive care units. We hypothesized that the presence of specific microbiota in the endotracheal aspirate during the intubation procedure was associated with clinical outcomes such as intubation failure or 28-day mortality. 216 endotracheal aspirates were obtained on days 1, 3, and 7 from 60 mechanically ventilated intensive care unit patients (41 with pneumonia and 19 with non-pneumonia). Twenty-two patients successfully prolapsed within 3 weeks and 12 patients died within 28 days. The microbiome profile was significantly different between the pneumonic and non-pneumonic groups (Adonis, Po0.01). The α-diversity (Shannon index) decreased significantly between days 1 and 7 in the successful extubation group, whereas it did not decrease in the unsuccessful extubation group among intubated patients with pneumonia. In Bray-Curtis distance between talgwan talgwan success group and the failure group had a significant difference between the α- diversity changes (P <0.001). Rotia, Streptococcus and Pribotella correlated with changes in α-diversity at the genus level. The relative abundance of Streptococcus at the time of intubation was closely related to the 28-day mortality rate. Epidemiology of the respiratory microbiome is associated with clinical outcomes such as prolapse failure and mortality.
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