[The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia (VAP)].

Anestezjologia intensywna terapia Pub Date : 2011-04-01
Wojciech Kowalczyk, Zbigniew Rybicki, Dariusz Tomaszewski, Andrzej Truszczyński, Aneta Guzek
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Abstract

Background: Although broncho-alveolar lavage (BAL) culture and protected specimen brush (PSB) are regarded as the most effective methods in the diagnosis of VAP, a simple endotracheal aspiration (EA) is frequently performed during routine care, because of its simplicity and low cost. We compared the effectiveness of EA with BAL and PSB in VAP patients.

Methods: Sixty-one adult VAP patients, ventilated for longer than 48 h, were cultured with all three methods.

Results: Positive cultures were obtained from 63.9% of patients, with Acinetobacter baumannii being the most common pathogen. There was a high positive correlation between simple aspirates and BAL (k 0.817, CI 0.664-0.840, p <0.001) and aspirates and PSB (k 0.667, CI 0.483-0.871, p <0.001).

Conclusion: Because of the high sensitivity of bronchial aspirate culturing, compared to BAL and PSB, it can be used successfully in most cases.

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[呼吸机相关性肺炎(VAP)患者不同支气管吸入培养方法的比较]。
背景:虽然支气管肺泡灌洗(BAL)培养和保护标本刷(PSB)被认为是诊断VAP最有效的方法,但简单的气管内吸吸(EA)因其简单且成本低,在常规护理中经常进行。我们比较了EA与BAL和PSB在VAP患者中的疗效。方法:对通气超过48 h的成人VAP患者61例,采用三种方法培养。结果:63.9%的患者培养阳性,最常见的病原菌为鲍曼不动杆菌。结论:与BAL和PSB相比,支气管吸痰培养具有较高的敏感性,可在大多数病例中成功应用。
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