title: [The role of endotracheal aspiration in the diagnosis of ventilator associated pneumonia].
abstract: BACKGROUND
  Ventilator associated pneumonia (VAP) is one of the most important causes of mortality in patients treated with invasive mechanical ventilation (IMV) in intensive care unit (ICU). Microbiological examinations are required as clinical and radiological findings are usually insufficient in the diagnosis.
  
  
  METHODS
  Twenty four patients who were receiving IMV because of respiratory failure, had a Clinical Pulmonary Infection Score (CPIS) of ≥ 6 in the follow-up and died with the suspicion of VAP were enrolled in our study. Six patients were excluded as post-mortem biopsy could not be performed. The patients who had pre-mortem CPIS ≥ 6, in whom a causative organism was identified from the culture of post-mortem lung biopsy and/or histopathological examination of lung biopsy was compatible with pneumonia were diagnosed as VAP. In the 18 patients in whom a post-mortem lung biopsy was performed, quantitative culture results of endotracheal aspirate performed 48 hours prior to death were compared with microbiological and histopathological results of post-mortem lung biopsy specimens, and the role of endotracheal aspirate in the diagnosis of VAP was evaluated retrospectively.
  
  
  RESULTS
  Out of 18 patients (12 men, mean age 67.0 ± 13.0 years) included in the study, 11 (61.1%) were diagnosed as VAP. The quantitative culture of endotracheal aspirate was positive in 9 (81.8%) out of 11 patients diagnosed as VAP. The sensitivity, specificity, positive and negative predictive values of endotracheal aspirate culture for identifying VAP were found to be 81.8%, 14.3%, 60.0% and 33.3%, respectively.
  
  
  CONCLUSIONS
  Our study shown that quantitative culture of endotracheal aspirate is a practical and reliable method that can be used for the diagnosis of VAP in patients receiving IMV in ICU and having CPIS ≥ 6.
authors: Alev
authors: A
authors: Gürgün
authors: Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey. pervinkorkmaz@yahoo.com.
authors: Pervin
authors: P
authors: Korkmaz Ekren
authors: Feza
authors: F
authors: Bacakoğlu
authors: Ozen Kaçmaz
authors: OK
authors: Başoğlu
authors: Nigar
authors: N
authors: Dirican
authors: Şöhret
authors: Ş
authors: Aydemir
authors: Deniz
authors: D
authors: Nart
authors: Abdullah
authors: A
authors: Sayıner
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D012121:Respiration, Artificial / Q000009:adverse effects*; D053120:Respiratory Aspiration / Q000150:complications*; D012189:Retrospective Studies; D013396:Suction / Q000009:adverse effects