Quantitative tracheal lavage versus bronchoscopic protected specimen brush for the diagnosis of nosocomial pneumonia in mechanically ventilated patients
| Autor: | Ravishankar Kamath, Miguel Bongera, Jeffrey O. Phillips, John A. Aucar, Michael H. Metzler |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Colony Count Microbial Sensitivity and Specificity Gastroenterology law.invention Bronchoscopy Predictive Value of Tests law Internal medicine Positive predicative value Pneumonia Bacterial medicine Humans Prospective Studies Aged Cross Infection Cross-Over Studies medicine.diagnostic_test business.industry Respiratory disease General Medicine Gold standard (test) Middle Aged medicine.disease Respiration Artificial Trachea Pneumonia Gram staining Case-Control Studies Predictive value of tests Protected specimen brush Female Surgery business Bronchoalveolar Lavage Fluid |
| Zdroj: | The American Journal of Surgery. 186:591-596 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2003.08.005 |
| Popis: | Background No gold standard method exists for the diagnosis of ventilator-associated pneumonia despite the availability of multiple techniques. Methods A prospective, crossover study was performed on mechanically ventilated patients meeting with suspected pneumonia. Eighteen paired samples were obtained on 15 patients, comparing the results of quantitative tracheal lavage (QTL) to bronchoscopic protected brush specimen (PSB) by quantitative culture and gram stain examination. Results The sensitivity, specificity, positive and negative predictive values, and accuracy are affected by the growth density threshold selected, and whether the same organisms are expected by both methods. There is a significant relationship between QTL and PSB ( P = 0.0048; R = 0.632), gram stain and PSB ( P R = 0.791), and gram stain and QTL ( P = 0.0125; R = 0.575), by Spearman rank order correlation. Conclusions QTL may have a role for diagnosing and directing treatment of ventilator-associated pneumonia, allowing reservation of bronchoscopic PSB for secondary, high risk and refractory cases. |
| Databáze: | OpenAIRE |
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