Observational studyCritical care (London, England)2012
Implications of endotracheal tube biofilm in ventilator-associated pneumonia response: a state of concept.
Observational study in Critical care (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02284438 (Innovation Against Infection - Device Related Infections - Part ETT), which is not on this map. Cited by 99 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Innovation Against Infection - Device Related Infections - Part ETT
Who cites it
99 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Biofilm Formation on Endotracheal and Tracheostomy Tubing: A Systematic Review and Meta-Analysis of Culture Data and Sampling Method.MicrobiologyOpen · 2025Pooled it
- Application of double-sleeve endotracheal tube in infection control for icu patients: a randomized controlled trial.Head & face medicine · 2025Trial
- Trial
- Silver-Coated Endotracheal Tubes Cleaned With a Mechanism for Secretion Removal.Respiratory care · 2019Trial
- Tolerability and performance of BIP endotracheal tubes with noble metal alloy coating--a randomized clinical evaluation study.BMC anesthesiology · 2015Trial
- Genomic and phenotypic heterogeneity of Klebsiella aerogenes in a single host: plasmid loss and tissue-specific virulence gene expression during host adaptation.International microbiology : the official journal of the Spanish Society for Microbiology · 2026Article
- Nanostructured Hydrogels: A Method to Prevent Biofilms on Implantable Medical Devices.Gels (Basel, Switzerland) · 2026Review
- Biofilm communities above and below the cuff of endotracheal tubes are spatially homogenous.Respiratory research · 2026Observational
- UnderstandingMicroorganisms · 2026Review
- Oral Hygiene Interventions and Pneumonia Prevention in Critical Care: An Integrative Review of Evidence and Practice.International journal of dentistry · 2026Review
- Article
- Airway hydration homeostasis in artificial airways: from mucus biophysics to monitoring and humidification strategies in critical care: a narrative review.Frontiers in medicine · 2026Review
- Analyzing the effects of benzodiazepines on the virulence and biofilm formation of Pseudomonas aeruginosa.Scientific reports · 2025Article
- Invasive ventilator exhaust in critical care: aerosol transmission risks and management strategies-a narrative review.Critical care (London, England) · 2025Review
- 2024 Year in Review: Ventilator-Associated Pneumonia.Respiratory care · 2025Review
- Immune system dynamics in response to Pseudomonas aeruginosa biofilms.NPJ biofilms and microbiomes · 2025Review
- tesG expression as a potential clinical biomarker for chronic Pseudomonas aeruginosa pulmonary biofilm infections.BMC medicine · 2025Article
- Towards a holistic approach to pulmonary infections. Insights from the Sixth Annual Meeting of Spanish Experts 2024.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Effects of endotracheal suctioning duration cerebral oxygenation in preterm infants.Journal of clinical nursing · 2025Observational
- Recreating chronic respiratory infectionsEuropean respiratory review : an official journal of the European Respiratory Society · 2024Review
39 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBiofilm in endotracheal tubes (ETT) of ventilated patients has been suggested to play a role in the development of ventilator-associated pneumonia (VAP). Our purpose was to analyze the formation of ETT biofilm and its implication in the response and relapse of VAP.
methodsWe performed a prospective, observational study in a medical intensive care unit. Patients mechanically ventilated for more than 24 hours were consecutively included. We obtained surveillance endotracheal aspirates (ETA) twice weekly and, at extubation, ETTs were processed for microbiological assessment and scanning electron microscopy.
resultsEighty-seven percent of the patients were colonized based on ETA cultures. Biofilm was found in 95% of the ETTs. In 56% of the cases, the same microorganism grew in ETA and biofilm. In both samples the most frequent bacteria isolated were Acinetobacter baumannii and Pseudomonas aeruginosa. Nineteen percent of the patients developed VAP (N = 14), and etiology was predicted by ETA in 100% of the cases. Despite appropriate antibiotic treatment, bacteria involved in VAP were found in biofilm (50%). In this situation, microbial persistence and impaired response to treatment (treatment failure and relapse) were more frequent (100% vs 29%, P = 0.021; 57% vs 14%, P = 0.133).
conclusionsAirway bacterial colonization and biofilm formation on ETTs are early and frequent events in ventilated patients. There is microbiological continuity between airway colonization, biofilm formation and VAP development. Biofilm stands as a pathogenic mechanism for microbial persistence, and impaired response to treatment in VAP.
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