Quantitative tracheal lavage versus bronchoscopic protected specimen brush for the diagnosis of nosocomial pneumonia in mechanically ventilated patients

No gold standard method exists for the diagnosis of ventilator-associated pneumonia despite the availability of multiple techniques. A prospective, crossover study was performed on mechanically ventilated patients meeting with suspected pneumonia. Eighteen paired samples were obtained on 15 patients...

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Bibliographic Details
Published in:The American journal of surgery 2003-12, Vol.186 (6), p.591-596
Main Authors: Aucar, John A, Bongera, Miguel, Phillips, Jeffrey O, Kamath, Ravishankar, Metzler, Michael H
Format: Article
Language:English
Subjects:
Accuracy
Adult
Aged
Antibiotics
Biological and medical sciences
Bronchoalveolar Lavage Fluid - microbiology
Bronchoscopy
Case-Control Studies
Catheters
Colony Count, Microbial
Cross Infection - diagnosis
Cross Infection - etiology
Cross-Over Studies
Diagnosis
E coli
Female
Humans
Infections
Influenza
Intensive care
Investigative techniques, diagnostic techniques (general aspects)
Male
Mechanical ventilation
Medical sciences
Methods
Middle Aged
Mortality
Ostomy
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Patients
Pneumonia
Pneumonia, Bacterial - diagnosis
Pneumonia, Bacterial - etiology
Pneumonia, Bacterial - microbiology
Predictive Value of Tests
Prospective Studies
Respiration, Artificial - adverse effects
Respiratory system
Sensitivity and Specificity
Suctioning
Teaching hospitals
Trachea - microbiology
Tracheal lavage
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Summary:No gold standard method exists for the diagnosis of ventilator-associated pneumonia despite the availability of multiple techniques. A prospective, crossover study was performed on mechanically ventilated patients meeting with suspected pneumonia. Eighteen paired samples were obtained on 15 patients, comparing the results of quantitative tracheal lavage (QTL) to bronchoscopic protected brush specimen (PSB) by quantitative culture and gram stain examination. The sensitivity, specificity, positive and negative predictive values, and accuracy are affected by the growth density threshold selected, and whether the same organisms are expected by both methods. There is a significant relationship between QTL and PSB ( P = 0.0048; R = 0.632), gram stain and PSB ( P
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2003.08.005