Endotracheal Aspirate Microscopy, Cultures and Endotracheal Tube Tip Cultures for Early Prediction of Ventilator Associated Pneumonia in Neonates.
OBJECTIVE
To evaluate the utility of endotracheal aspirate microscopy, culture and endotracheal tube tip culture for early diagnosis of ventilator-associated pneumonia in neonates.


METHODS
Inborn ventilated neonates were followed-up for ventilator-associated pneumonia using Center for Disease Control and Prevention (CDC) criteria. Endotracheal aspirate microscopy, culture and endotracheal tube tip cultures were performed.


RESULTS
Ventilator-associated pneumonia occurred in 28/68 (41%) neonates as per CDC criteria. Endotracheal aspirate microscopy (≥5 polymorphonuclear cells per high power field) and endotracheal aspirate culture had 78.6% and 75% sensitivity, 87.5% and 90% specificity, positive predictive value of 81.5% and 84%, and negative predictive value of 85.4% and 83.72%, respectively. Mean (SD) time of result of microscopy and endotracheal aspirate culture was 55.7 (4.3) h and 108.3 (19.7) h, respectively in comparison to diagnosis made at 143.5 (23.3) h, as per CDC criteria.


CONCLUSIONS
Endotracheal aspirate microscopic examination and culture can be supportive in objective diagnosis of ventilator-associated pneumonia with an added advantage of earlier prediction.
Departments of Neonatology and *Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion. Mumbai, India. Correspondence to: Dr Mahendra Kumar Gupta, Department of Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai 400 022, India. mkgupta.nhrc@gmail.com.
Mahendra Kumar
MK
Gupta
Jayashree
J
Mondkar
Anjali
A
Swami
Deepraj
D
Hegde
Sorabh
S
Goel
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation*; D008297:Male; D008828:Microbiological Techniques; D008853:Microscopy; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D013523:Surgical Equipment / Q000382:microbiology*