[Impact of quantitative and qualitative pathogen culture on the outcome of ventilator-associated pneumonia].
OBJECTIVE
To evaluate the impact diagnostic methods with either quantitative culture (QC) or qualitative routine culture (RC) on the outcome of VAP.


METHODS
A prospective, controlled clinical trial in 93 consecutive VAP episodes of 31 patients receiving mechanical ventilation was conducted. VAP episodes were randomly and crossly divided into QC (43 episodes, underwent FOB-PSB-QC) and RC group (50 episodes, underwent ETA-RC). Empirical antibiotic treatment was given according to the attending physician and modified according to the results of culture and sensitivity. The outcomes of VAP were assessed.


RESULTS
There were no differences with regard to mortality, super-infection rate, antibiotic resistance rate and cost of antibiotics when comparing QC versus RC diagnostic methods and management based on two diagnostic strategies. Inappropriate initial empirical antibiotic treatment led to a higher mortality (17.7%) when compared with those with appropriate treatment.


CONCLUSIONS
The present study demonstrates that the outcome of VAP is probably more dependent on the adequacy of the initial antibiotic treatment than on the use of either diagnostic sampling.
Cai
S
S
General Hospital of PLA, Beijing 100853, China.
Zhang
J
J
Qian
G
G
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012122:Ventilators, Mechanical / Q000009:adverse effects*
D000900:Anti-Bacterial Agents