Wednesday, March 23, 2011

The joy of handling peer review of 200 articles

Below is my 200th editorial assignment at PLoS ONE which went live recently. On this occasion, I am grateful to the management, in house editors and staff of PLoS ONE for entrusting and reposing their confidence in me, and for the authors who did not loose patience, and for hundreds of colleagues who reviewed these manuscripts on more than one occasion and assisted me in keeping to the time frames. All the articles handled by me at ONE can be accessed here. Below is the 200th article signed off by me as an Academic Editor.

Molecular Analysis of Microbial Communities in Endotracheal Tube Biofilms

Cairns S, Thomas JG, Hooper SJ, Wise MP, Frost PJ, et al. (2011) Molecular Analysis of Microbial Communities in Endotracheal Tube Biofilms. PLoS ONE 6(3): e14759. doi:10.1371/journal.pone.0014759


Ventilator-associated pneumonia is the most prevalent acquired infection of patients on intensive care units and is associated with considerable morbidity and mortality. Evidence suggests that an improved understanding of the composition of the biofilm communities that form on endotracheal tubes may result in the development of improved preventative strategies for ventilator-associated pneumonia.

Methodology/Principal Findings

The aim of this study was to characterise microbial biofilms on the inner luminal surface of extubated endotracheal tubes from ICU patients using PCR and molecular profiling. Twenty-four endotracheal tubes were obtained from twenty mechanically ventilated patients. Denaturing gradient gel electrophoresis (DGGE) profiling of 16S rRNA gene amplicons was used to assess the diversity of the bacterial population, together with species specific PCR of key marker oral microorganisms and a quantitative assessment of culturable aerobic bacteria. Analysis of culturable aerobic bacteria revealed a range of colonisation from no growth to 2.1×108 colony forming units (cfu)/cm2 of endotracheal tube (mean 1.4×107 cfu/cm2). PCR targeting of specific bacterial species detected the oral bacteria Streptococcus mutans (n = 5) and Porphyromonas gingivalis (n = 5). DGGE profiling of the endotracheal biofilms revealed complex banding patterns containing between 3 and 22 (mean 6) bands per tube, thus demonstrating the marked complexity of the constituent biofilms. Significant inter-patient diversity was evident. The number of DGGE bands detected was not related to total viable microbial counts or the duration of intubation.


Molecular profiling using DGGE demonstrated considerable biofilm compositional complexity and inter-patient diversity and provides a rapid method for the further study of biofilm composition in longitudinal and interventional studies. The presence of oral microorganisms in endotracheal tube biofilms suggests that these may be important in biofilm development and may provide a therapeutic target for the prevention of ventilator-associated pneumonia.

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