The respiratory microbiota during and following mechanical ventilation for respiratory infections in children

The lower respiratory tract (LRT) harbours distinct, dynamic low-density microbial communities, established through micro-aspiration from the upper respiratory tract (URT) [1–3]. However, during intubation and mechanical ventilation, the endotracheal tube temporarily alters the anatomical continuity between URT and LRT, and may provide a bridge for airborne microbes and a barrier for micro-aspiration. Shortly after intubation for a severe LRT infection (LRTI) in children, the microbiota of the nasopharynx and LRT were shown to be very similar [4]. However, it remains unknown how the respiratory microbial community develops while the child recovers from the infection under treatment with mechanical ventilation and antibiotics. We therefore analysed respiratory microbiota changes in children participating in our study on acute LRTIs and who were admitted to the paediatric intensive care unit (PICU) for mechanical ventilation [4]. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Drs. de Koff has nothing to disclose. Conflict of interest: Dr. Man has nothing to disclose. Conflict of interest: Dr. van Houten has nothing to disclose. Conflict of interest: Dr. Jansen has nothing to disclose. Conflict of interest: K. Arp has nothing to disclose. Conflict of interest: Drs. Hasrat has nothing to disclose. Conflict of interest: Dr. Sanders has nothing to disclose. Conflict of interest: Dr. Bogaert has nothing to disclose.