[The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia (VAP)].
BACKGROUND
Although broncho-alveolar lavage (BAL) culture and protected specimen brush (PSB) are regarded as the most effective methods in the diagnosis of VAP, a simple endotracheal aspiration (EA) is frequently performed during routine care, because of its simplicity and low cost. We compared the effectiveness of EA with BAL and PSB in VAP patients.


METHODS
Sixty-one adult VAP patients, ventilated for longer than 48 h, were cultured with all three methods.


RESULTS
Positive cultures were obtained from 63.9% of patients, with Acinetobacter baumannii being the most common pathogen. There was a high positive correlation between simple aspirates and BAL (k 0.817, CI 0.664-0.840, p <0.001) and aspirates and PSB (k 0.667, CI 0.483-0.871, p <0.001).


CONCLUSIONS
Because of the high sensitivity of bronchial aspirate culturing, compared to BAL and PSB, it can be used successfully in most cases.
Department of Anaesthesiology and Intensive Therapy, Military Institute of Medicine in Warsaw,Warszawa.
Wojciech
W
Kowalczyk
Zbigniew
Z
Rybicki
Dariusz
D
Tomaszewski
Andrzej
A
Truszczyński
Aneta
A
Guzek
D000328:Adult; D001980:Bronchi / Q000382:microbiology; D018893:Bronchoalveolar Lavage / Q000379:methods*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D015169:Colony Count, Microbial; D005260:Female; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis* / Q000382:microbiology; D011044:Poland; D012680:Sensitivity and Specificity; D013396:Suction / Q000379:methods; D014132:Trachea / Q000382:microbiology; D012122:Ventilators, Mechanical / Q000009:adverse effects* / Q000382:microbiology