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Quantitative cultures of endotracheal aspirates for the diagnosis of ventilator-associated pneumonia.
Am Rev Respir Dis. 1993 Dec; 148(6 Pt 1):1552-7.AR

Abstract

Bronchoalveolar lavage (BAL) and protected specimen brushing (PSB) are the most commonly used methods for diagnosing ventilator-associated (VA) pneumonia although they require bronchoscopy. Endotracheal aspiration (EA) is a simple and less costly technique than PSB or BAL. The purpose of our study was to investigate the diagnostic value of EA quantitative cultures and to compare the results obtained using EA with those obtained using PSB and BAL in mechanically ventilated patients with or without pneumonia. We prospectively studied 102 intubated patients divided into three diagnostic categories: Group I (definite pneumonia, n = 26), Group II (uncertain status, n = 48), and Group III (control group, n = 28). All patients received prior antibiotic treatment. EA, PSB, and BAL were obtained sequentially in all patients. When comparing Group I with Group III and using 10(5) cfu/ml as a threshold, we found that EA quantitative cultures represented a relatively sensitive (70%) and relatively specific (72%) method to diagnose VA pneumonia. The specificity of BAL and PSB (87% and 93%, respectively) was better than that of EA. The negative predictive value of EA cultures was higher (72%) when compared with that obtained using PSB (34%) (p < 0.05). EA quantitative cultures correlated with PSB and BAL quantitative cultures in patients with definite pneumonia. Although EA quantitative cultures are less specific than PSB and BAL for diagnosing VA pneumonia, our results suggest that the former approach may be used to treat these patients when bronchoscopic procedures are not available.

Authors+Show Affiliations

Servei de Pneumologia i Al.lèrgia Respiratoria, Hospital Clínic, Facultat de Medicina, Universitat de Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8256899

Citation

el-Ebiary, M, et al. "Quantitative Cultures of Endotracheal Aspirates for the Diagnosis of Ventilator-associated Pneumonia." The American Review of Respiratory Disease, vol. 148, no. 6 Pt 1, 1993, pp. 1552-7.
el-Ebiary M, Torres A, González J, et al. Quantitative cultures of endotracheal aspirates for the diagnosis of ventilator-associated pneumonia. Am Rev Respir Dis. 1993;148(6 Pt 1):1552-7.
el-Ebiary, M., Torres, A., González, J., de la Bellacasa, J. P., García, C., Jiménez de Anta, M. T., Ferrer, M., & Rodriguez-Roisin, R. (1993). Quantitative cultures of endotracheal aspirates for the diagnosis of ventilator-associated pneumonia. The American Review of Respiratory Disease, 148(6 Pt 1), 1552-7.
el-Ebiary M, et al. Quantitative Cultures of Endotracheal Aspirates for the Diagnosis of Ventilator-associated Pneumonia. Am Rev Respir Dis. 1993;148(6 Pt 1):1552-7. PubMed PMID: 8256899.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative cultures of endotracheal aspirates for the diagnosis of ventilator-associated pneumonia. AU - el-Ebiary,M, AU - Torres,A, AU - González,J, AU - de la Bellacasa,J P, AU - García,C, AU - Jiménez de Anta,M T, AU - Ferrer,M, AU - Rodriguez-Roisin,R, PY - 1993/12/1/pubmed PY - 1993/12/1/medline PY - 1993/12/1/entrez SP - 1552 EP - 7 JF - The American review of respiratory disease JO - Am Rev Respir Dis VL - 148 IS - 6 Pt 1 N2 - Bronchoalveolar lavage (BAL) and protected specimen brushing (PSB) are the most commonly used methods for diagnosing ventilator-associated (VA) pneumonia although they require bronchoscopy. Endotracheal aspiration (EA) is a simple and less costly technique than PSB or BAL. The purpose of our study was to investigate the diagnostic value of EA quantitative cultures and to compare the results obtained using EA with those obtained using PSB and BAL in mechanically ventilated patients with or without pneumonia. We prospectively studied 102 intubated patients divided into three diagnostic categories: Group I (definite pneumonia, n = 26), Group II (uncertain status, n = 48), and Group III (control group, n = 28). All patients received prior antibiotic treatment. EA, PSB, and BAL were obtained sequentially in all patients. When comparing Group I with Group III and using 10(5) cfu/ml as a threshold, we found that EA quantitative cultures represented a relatively sensitive (70%) and relatively specific (72%) method to diagnose VA pneumonia. The specificity of BAL and PSB (87% and 93%, respectively) was better than that of EA. The negative predictive value of EA cultures was higher (72%) when compared with that obtained using PSB (34%) (p < 0.05). EA quantitative cultures correlated with PSB and BAL quantitative cultures in patients with definite pneumonia. Although EA quantitative cultures are less specific than PSB and BAL for diagnosing VA pneumonia, our results suggest that the former approach may be used to treat these patients when bronchoscopic procedures are not available. SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/8256899/Quantitative_cultures_of_endotracheal_aspirates_for_the_diagnosis_of_ventilator-associated_pneumonia. L2 - https://www.atsjournals.org/doi/10.1164/ajrccm/148.6_Pt_1.1552?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -