title: [Validity comparison of various biological samples from lower airway and their contribution for the detection of nosocomial pneumonia etiological agents].
abstract: BACKGROUND
  The aim of the study was to compare the validity of bronchial secretion sampling and bronchoscopy-assisted protected specimen brushing (PSB) in patients with hospital-acquired pneumonia (HAP).
  
  
  METHODS
  In patients with HAP, bronchial secretion samples (aspiration of lower airway secretions from an orotracheal tube with a suctioning catheter) and PSB (bronchoscopy-assisted sampling from the most affected area of the lung, verified by CT scan) were taken at the same time. Both samples were processed by semiquantitative routine microbiological techniques. Identification of microorganisms was performed by standard microbiological techniques using the MALDI-TOF automated system. For similarity or identity determination of bacterial isolates from bronchial secretion sampling and PSB, pulsed-field gel electrophoresis was used.
  
  
  RESULTS
  Thirty patients were enrolled into the study. Thirty pairs of bronchial secretion samples and PSB samples were obtained and processed. The samples were positive in 23 patients (77 %) and 15 patients (50 %), respectively. In 15 cases, the same pathogen was determined in both samples, and in all those cases, the isolates were genetically identical.
  
  
  CONCLUSIONS
  The results of the study show that bronchial secretion samples analysis enabled identification of all pathogens that were identified by PSB. Given the high sensitivity of the bronchial secretion aspiration technique and genetic identity of isolates in both samples, bronchial secretion sampling may be recommended for determining HAP etiological agents as the samples are much easier to obtain from patients.
authors.affiliation: Palacky University, University Hospital and Faculty of Medicine, Department of Anaesthesiology and Intensive Care Medicine, Olomouc, Czech Republic, e-mail: Tomas.Gabrhelik@fnol.cz.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Gabrhelík
authors.forename: Vojtěch
authors.initials: V
authors.lastname: Hanulík
authors.forename: Petr
authors.initials: P
authors.lastname: Jakubec
authors.forename: Radomír
authors.initials: R
authors.lastname: Uvízl
authors.forename: Lenka
authors.initials: L
authors.lastname: Doubravská
authors.forename: Magdaléna
authors.initials: M
authors.lastname: Röderová
authors.forename: Milan
authors.initials: M
authors.lastname: Adamus
authors.forename: Vítězslav
authors.initials: V
authors.lastname: Kolek
authors.forename: Milan
authors.initials: M
authors.lastname: Kolář
mesh_terms: D000328:Adult; D000368:Aged; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001999:Bronchoscopy; D003428:Cross Infection / Q000175:diagnosis* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000382:microbiology*; D013048:Specimen Handling