[Pneumonia in artificially ventilated patients: the significance of Gram preparation und bronchoscopic specimen collection methods in diagnosis and therapy].
The value of the Gram preparation of tracheal secretion compared to bacterial culture was checked in 48 patients with lower respiratory tract infections under mechanical ventilation with regard to antibiotic therapy. In 20 patients attention was also paid to the information value of a bronchial secretion obtained bronchoscopically using a brush. In 34 patients (71%) there was an exact agreement between the result of the Gram preparation and that of the culture. The antibiotic therapy initially administered on the basis of the Gram preparation from the tracheal secretion had to be corrected in 6 patients (12.5%) according to the culture and resistance results and in 6 patients (12.5%) because clinical improvement had not occurred after three days. Only 67% of the bacteria found in the tracheal secretion were isolated also with the bronchoscopic brush technique. The antibiotic therapy was not altered on the basis of the result obtained by bronchoscopy in any case. We conclude that for calculated antibiotic therapy Gram preparation has great significance. Bronchoscopic methods of obtaining material did not influence antibiotic therapy in bacterial pneumonia.
Konrad
F
F
Universitätsklinik für Anästhesiologie, Klinikum der Universität Ulm.
Deller
A
A
Behrend
B
B
Schwalbe
B
B
Wiedeck
H
H
D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D001431:Bacteriological Techniques / Q000295:instrumentation; D020680:Bronchoscopes; D001999:Bronchoscopy; D003422:Critical Care; D004352:Drug Resistance, Microbial; D005840:Gentian Violet; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D010619:Phenazines; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology*; D013194:Staining and Labeling; D014132:Trachea / Q000382:microbiology*
C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet
Pneumonie bei beatmeten Patienten: Bedeutung des Grampräparates und bronchoskopischer Materialgewinnungs-Methoden in der Diagnostik und Therapie.