The accuracy of elevated concentrations of endotoxin in bronchoalveolar lavage fluid for the rapid diagnosis of gram-negative pneumonia
| Autor: | Marin H. Kollef, Mark R. Wick, Paul R. Eisenberg, Matthew F. Ohlendorf |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male Pathology medicine.medical_specialty Time Factors Lung infection Biopsy Bronchi Critical Care and Intensive Care Medicine Sensitivity and Specificity law.invention law Risk Factors medicine Pneumonia Bacterial Humans Lung Receiver operating characteristic medicine.diagnostic_test business.industry Respiratory disease respiratory system Middle Aged medicine.disease Gram-negative pneumonia respiratory tract diseases Endotoxins Pneumonia Gram staining Bronchoalveolar lavage medicine.anatomical_structure ROC Curve Female business Gram-Negative Bacterial Infections Bronchoalveolar Lavage Fluid |
| Zdroj: | American journal of respiratory and critical care medicine. 154(4 Pt 1) |
| ISSN: | 1073-449X |
| Popis: | The purpose of this study was to determine the accuracy of elevated concentrations of endotoxin in bronchoalveolar lavage (BAL) fluid for the diagnosis of gram-negative pneumonia. Sixty-three hospitalized adults underwent 71 evaluations with BAL using quantitative cultures for suspected lung infection. A cutoff value of5 EU/ml for the concentration of endotoxin in BAL fluid yielded the best operating characteristics for the diagnosis of gram-negative pneumonia (sensitivity, 100%; specificity, 75.0%; area under receiver operating characteristic [ROC] curve, 0.88). Good diagnostic agreement was found between elevated concentrations of endotoxin in BAL fluid and microbiologically confirmed gram-negative pneumonia (kappa statistic, 0.64; concordance 83.1%). Gram stain examination of BAL fluid for the presence of gram-negative bacteria yielded inferior operating characteristics (sensitivity, 63.2%; specificity, 75.0%; area under ROC curve, 0.69). Poor diagnostic agreement was observed between BAL fluid Gram stain results and microbiologically confirmed gram-negative pneumonia (kappa statistic, 0.35; concordance, 71.8%). These findings suggest that a concentration of endotoxin in BAL fluid5 EU/ml is superior to Gram stain examination for the rapid identification of patients with gram-negative pneumonia. |
| Databáze: | OpenAIRE |
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