Effect of Previous Antimicrobial Therapy on the Accuracy of the Main Procedures Used to Diagnose Nosocomial Pneumonia in Patients Who are Using Ventilation
Autor: | Benoit Misset, Jean Carlet, Bertrand Renaud, Fred W. Goldstein, Jean-François Timsit |
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Rok vydání: | 1995 |
Předmět: |
Pulmonary and Respiratory Medicine
Artificial ventilation medicine.medical_specialty medicine.drug_class medicine.medical_treatment Antibiotics Critical Care and Intensive Care Medicine medicine.disease_cause Sensitivity and Specificity Bronchoscopy Internal medicine Pneumonia Bacterial medicine Fiber Optic Technology Humans Prospective Studies Aged Mechanical ventilation Cross Infection Bacteria medicine.diagnostic_test business.industry Environmental air flow Drug Resistance Microbial Middle Aged medicine.disease Respiration Artificial Anti-Bacterial Agents respiratory tract diseases Surgery Pneumonia Bronchoalveolar lavage Superinfection Drug Therapy Combination Cardiology and Cardiovascular Medicine business Bronchoalveolar Lavage Fluid |
Zdroj: | Scopus-Elsevier |
ISSN: | 0012-3692 |
Popis: | We evaluated the effect of antibiotic treatment received before the suspicion of pneumonia on the diagnostic yield of protected specimen brush (PSB), direct examination (BAL D) and culture (BAL C) of lavage fluid on consecutive mechanically ventilated patients with suspected nosocomial pneumonia. Bronchoscopy was always performed before any treatment for suspected pneumonia. One hundred and sixty-one patients with suspected pneumonia underwent PSB and BAL before any institution or change in antibiotic therapy (AB). Sixty-five patients received AB for an earlier septic episode (ON AB group) and 96 patients did not (OFF AB group). All but two strains recovered were highly resistant to previous AB. Sensitivity and specificity of each test were not different between the ON AB and OFF AB groups as well as the percentage of complete agreement between the 3 procedures, 74 and 67% respectively. We conclude that previous AB received to treat an earlier septic episode unrelated to suspected pneumonia do not affect the diagnostic yield of PSB and BAL. |
Databáze: | OpenAIRE |
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