S. Pneumoniae in VAP patients

1. María José García Tirado
Tercer Semestre
Universidad Pontificia Bolivariana
2019

2. Introduction
Pneumonia:
It its an infection that inflames alveoli of
one or both lungs. The air sacs can be
filled with liquid or pus (purulent
material), which causes cough with
phlegm or pus, fever, chills and difficult
breathing.
Pneumonia its more serious in infants
and young children, people over 65, and
people with impaired health or immune
systems
https://www.mayoclinic.org/es-es/diseases-conditions/pneumonia/symptoms-causes/syc-20354204

3. Signs and symptoms of pneumonia
● Chest pain when breathing or coughing
● Disorientation or changes in mental perception (in adults 65 years of
age or older)
● Cough that can produce phlegm
● Fatigue
● Fever, perspiration and chills with tremor.
● Lower than normal body temperature (in adults over 65 and people
with a weak immune system)
● Nausea, vomiting or diarrhea.
● Difficulty breathing

4. Streptococcus pneumoniae
● It is a pathogenic microorganism capable of causing various infections and
severe invasive processes in humans.
● It is a Gram positive bacterium of 1.2-1.8 µm in length, which has an oval
shape.
● Almost exclusively human pathogen that causes a large number of
infections (pneumonia, sinusitis, peritonitis, etc.)
● Severe invasive processes (meningitis, sepsis, etc.), particularly in the
elderly, children and immunosuppressed people.
● It is the main microorganism that causes community-acquired pneumonia
(NAC) and invasive pneumococcal disease (IPD)
●
●
https://es.wikipedia.org/wiki/Streptococcus_pneumoniae

5. “Determine the prevalence
of bacteria agents of VAP
and evaluate the presence of
S. Pneumoniae in VAP
confirmed ICU patients”

6. Materials and
methods
Real Time PCR
● Real-time polymerase chain
reaction (real time PCR) is
commonly used to measure gene
expresion.
● It is more sensitive than
microarrays in detecting small
changes in expression but
requires more input RNA and is
less adaptable to
high-throughput studies.
● In this study it was used to
evaluate the presence of s.
pneumoniae in samples by
extracting DNA from specimens.

7. Materials and Methods
Direct Microscopy Examination
● Microscopy is the set of techniques and methods intended to
make visible the objects of study that by their small size, are
invisible for humans optic spectrum
● It is used to increase the visualization of the sample, in this
specific case, to be able to identify the streptococcus
pneumoniae and the other bacteria found in the VAP patients
samples.

8. Results

9. Demographic Data

10. Direct Microscopy and Microbial Patterns

11. ● Agarose Gel
Electrophoresis.
● Lane M, the
size-marker (100
bp)
● lane ATCC, control
positive
● lanes 1 and 2, two
positive samples
● lane N, negative
control.

12. Real-time PCR graphs for two positive samples

13. Author Contribution Was it true?
7. Ghafari H, Ghane M. Determination of
frequency of bacterial agent causing ventilator
associated pneumonia in the patients
hospitalized in the intensive care unit of
Tonkabon Shahid Rajaei Hospital by PCR
sequencing. Zahedan J Res Med Sci.
2017;19(3). e8039. doi: 10.5812/zjrms.8039.
Similar to other studies, our results showed that
VAP is more prevalent in elderly patients and is
more seen in men than women
Nomanpour B, Ghodousi A, Babaei T, Mousavi
SAJ, Asadi S, Feizabadi MM. Detection and
quantification of Streptococcus pneumoniae from
Iranian patients with pneumonia and individual
carriers by real time PCR. Afr J Biotechnol.
2011;10(60):12826–32. doi: 10.5897/ajb11.1466.
To date, several S. pneumoniae genes have
been used to detect the pathogen, among which
three most applied pneumococcal genes were
lytA, ply, and psaA that encode autolysin,
pneumolysin, and surface adhesion A,
respectively
Japoni A, Vazin A, Davarpanah MA, Afkhami
Ardakani M, Alborzi A, Japoni S, et al.
Ventilator-associated pneumonia in Iranian
intensive care units. J Infect Dev Ctries.
2011;5(4):286–93. [PubMed: 21537070].
The results of this study are consistent with our
findings. In addition, A. baumannii,
Methicillin-resistant S. aureus, and P. aeruginosa
were reported as the most prevalent bacteria
isolated from VAP in ICU patients

14. Conclusions
2. To conclude, it is a priority to
take into account the risk factors
to avoid early VAP patients,
especially in elderly which is the
most affected age rate. Smoking,
chronic obstructive pulmonary
disease and the lack of prior
antibiotic therapy are risks to
take into account.
3. To conclude, molecular
methods like real time PCR
are the most accurate in this
cases to determine not
prevalent bacterias like
streptococcus pneumoniae,
and additionally culture
results are not precise
enough.
1. To conclude, it is important to
take in account the important
role that streptococcus
pneumoniae has in the normal
nasopharyngeal flora,
nevertheless, it is not one of
the most prevalent bacteria
isolated from VAP in ICU
patients in Iran appearing
only in a 4.1% rate.