title: [Bacteriological study of bronchoalveolar lavage in the antibiotic management of suspected ventilator-associated pneumonia of patients in surgical intensive care units].
abstract: OBJECTIVE
  To determine the correlation of Gram staining with the culture of bronchoalveolar lavage in patients with clinical features of ventilator-associated pneumonia from two adult trauma and surgical intensive care units.
  
  
  METHODS
  We conducted a retrospective study of 252 samples of bronchoalveolar lavage from patients with clinical ventilator-associated pneumonia in trauma or surgical postoperative care. Gram staining samples were classified as Gram-positive cocci and Gram-negative bacilli, all other results being excluded. Cultures from bronchoalveolar lavage were compared with Gram staining results.
  
  
  RESULTS
  The correlation between Gram staining and culture from the bronchoalveolar lavage showed a kappa index of 0.27. The sensitivity of Gram staining was 53.9% and the specificity, 80.6%. Considering the identification of Gram-positive cocci against other results (negative and Gram-negative bacilli), the negative predictive value was 94.8%. The evaluation of Gram-negative bacilli against other results (negative and Gram-positive cocci) rendered a sensitivity of 27.1% and a specificity of 95.4%.
  
  
  CONCLUSIONS
  It appears that the negative predictive value for Gram-positive cocci is acceptable, but the sensitivity of Gram staining in the etiology of ventilator-associated pneumonia was not able to identify the microorganism before culture.
authors.affiliation: Programa de Pós Graduação em Princípios da Cirurgia, Instituto de Pesquisas Médicas, Faculdade Evangélica do Paraná, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil. flptuon@gmail.com
authors.forename: Felipe Francisco
authors.initials: FF
authors.lastname: Tuon
authors.forename: Lucas Wagner
authors.initials: LW
authors.lastname: Gortz
authors.forename: Sergio Ricardo
authors.initials: SR
authors.lastname: Penteado-Filho
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Soltoski
authors.forename: Alexandre Yoshio
authors.initials: AY
authors.lastname: Hayashi
authors.forename: Marcelo Tizzot
authors.initials: MT
authors.lastname: Miguel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001431:Bacteriological Techniques; D018893:Bronchoalveolar Lavage; D002648:Child; D005260:Female; D005840:Gentian Violet; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010619:Phenazines; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet