{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T21:26:06Z","timestamp":1789161966405,"version":"build-2803163510"},"reference-count":55,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T00:00:00Z","timestamp":1705276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Chronic obstructive pulmonary disease (COPD) is a major health concern. Acute exacerbations (AECOPD) may require intensive care unit (ICU) admission and mechanical ventilation. Acute infections and chronic colonization of the respiratory system are known to precipitate AECOPD. Detailed knowledge of the respiratory microbiome could lead to effective treatment and prevention of exacerbations. Objective: The aim of this review is to summarize the available evidence on the respiratory microbiome of patients with a severe AECOPD requiring mechanical ventilation and intensive care admission. Methods: A systematic literature search was conducted to identify the published papers until January 2023. The collected data were then subjected to qualitative analysis. After the first analysis, a secondary focused review of the most recent publications studying the relationship between microbiome and mortality in AECOPD was performed. Results: Out of 120 screened articles six articles were included in this review. Potentially pathogenic microorganisms (PPMs) were identified in 30% to 72% of the patients with community-acquired bacteria, gram-negative enteric bacilli, Stenotrophomonas and Pseudomonas being the most frequently isolated. During hospitalization, 21% of patients experienced colonization by PPMs. Adequate antimicrobial therapy resulted in the eradication of 77% of the identified PPMs. However, 24% of the bacteria displayed multi-drug resistance leading to prolonged or failure of eradication. Conclusion: PPMs are prevalent in a significant proportion of patients experiencing an AECOPD. The most identified PPMs include community-acquired pathogens and gram-negative enteric bacilli. Notably, no differences in mortality or duration of ventilation were observed between patients with and without isolated PPMs. However, the included studies did not investigate the virome of the patients, which may influence the microbiome and the outcome of infection. Therefore, further research is essential to comprehensively investigate the complete microbial and viral composition of the lower respiratory system in COPD patients admitted to the ICU.<\/jats:p>","DOI":"10.3390\/jcm13020472","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T07:25:07Z","timestamp":1705303507000},"page":"472","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Systematic Review of the Pulmonary Microbiome in Patients with Acute Exacerbation COPD Requiring ICU Admission"],"prefix":"10.3390","volume":"13","author":[{"given":"Sjoerd","family":"van der Bie","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Haaksma","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Vermin","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidde","family":"van Assema","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric C. M.","family":"van Gorp","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus MC, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Langerak","sequence":"additional","affiliation":[{"name":"Department of Viroscience, Erasmus MC, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Endeman","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Snijders","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes P. C.","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies A.","family":"van Houten","sequence":"additional","affiliation":[{"name":"Department of Pediatric Medicine, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven F. L.","family":"van Lelyveld","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Goeijenbier","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis Hoofddorp, 2134 TM Hoofddorp, The Netherlands"},{"name":"Department of Viroscience, Erasmus MC, 3000 CA Rotterdam, The Netherlands"},{"name":"Department of Intensive Care Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1016\/S0140-6736(12)61728-0","article-title":"Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Lozano","year":"2012","journal-title":"Lancet"},{"key":"ref_2","first-page":"170103","article-title":"Exacerbations of COPD","volume":"27","author":"Viniol","year":"2018","journal-title":"Eur. 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