title: Diagnosis of ventilator-associated pneumonia: comparison between ante-mortem and post-mortem cultures in trauma patients.
abstract: OBJECTIVE
  To evaluate the diagnostic utility of ante-mortem tracheal aspirates for diagnosis of ventilator-associated pneumonia (VAP). Trauma victims represent an otherwise healthy population, who are on multiple invasive life-support devices, which predispose them to severe infections like VAP. The diagnosis of VAP is challenging, due to the difficulty in obtaining a representative sample from lungs. We studied the diagnostic utility of tracheal aspirates by comparing its results with the post-mortem lung cultures.
  
  
  METHODS
  A total of 106 fatal trauma patients were included in the study. Lung samples and cardiac blood were taken for culture at the time of autopsy. The results of ante-mortem and post-mortem cultures were compared.
  
  
  RESULTS
  Septicemia was the cause of death in 51 (48%) of the fatal cases and VAP was identified in 36 (34%) cases. A total of 96 (90.5%) cases had pathogens isolated from lung samples. In 62 (58%) cases, the same organism was isolated from ante-mortem and post-mortem respiratory samples.
  
  
  CONCLUSIONS
  Culture results of a properly collected tracheal aspirate should be taken into consideration along with Centre for Disease Control and Prevention (CDC's) diagnostic criteria to maximise the diagnosis of VAP.
authors.forename: S
authors.initials: S
authors.lastname: Lalwani
authors.affiliation: Departments of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Mathur
authors.forename: V
authors.initials: V
authors.lastname: Tak
authors.forename: S
authors.initials: S
authors.lastname: Janani
authors.forename: S I
authors.initials: SI
authors.lastname: Kumar
authors.forename: R
authors.initials: R
authors.lastname: Bagla
authors.forename: M C
authors.initials: MC
authors.lastname: Misra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis* / Q000382:microbiology*; D014132:Trachea / Q000382:microbiology; D014947:Wounds and Injuries / Q000150:complications* / Q000628:therapy*; D055815:Young Adult