| Journal: | Jornal brasileiro de pneumologia |
| Database: | PERIÓDICA |
| System number: | 000297382 |
| ISSN: | 1806-3713 |
| Authors: | Carvalho, Maria Veronica Costa Freire de1 Winkeler, Georgia Freire Paiva Costa, Fabricio Andre Martins Bandeira, Tereza de Jesus Gomes Pereira, Eanes Delgado Barros Holanda, Marcelo Alcantara |
| Institutions: | 1Hospital de Messejana, Servico de Pneumologia, Fortaleza, Ceara. Brasil |
| Year: | 2004 |
| Season: | Ene-Feb |
| Volumen: | 30 |
| Number: | 1 |
| Pages: | 26-38 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Caso clínico, analítico |
| English abstract | BACKGROUND: The value of endotracheal aspirate cultures and of the GRAM stain test for the etiologic diagnosis of ventilator-associated pneumonia (VAP) still remains controversial. OBJECTIVES: To assess the consistency between the results of quantitative cultures and GRAM stain tests of the endotracheal aspirates and the bronchoalveolar lavage in patients with VAP. METHOD: Between October/2001 and August/2002, we prospectively studied all patients under mechanical ventilation for more than 48 hours with clinical suspicion of VAP. At the time of clinical suspicion, an endotrachealaspirate followed by a bronchoalveolar lavage was performed. Diagnosis of VAP was defined when clinical suspicion was confirmed by a positive quantitative culture (>104cfu/ml) in the bronchoalveolar lavage. RESULTS: Among 119 patients, 32 (26.8%) were suspected of having VAP, with confirmation in 25 (78%). Comparison between GRAM test of endotracheal aspirates and culture results of the bronchoalveolar lavage showed a moderate consistency (Kappa coefficient: 0.56). The was consistency between quantitative cultures of endotracheal aspirate and bronoalveolar lavage in 22 (88%) at the patients and no consistency in 3 (12%). (Kappa coefficient: 0.71). The sensitivity and specificity of the endotracheal aspirate culture with cut off of 106 cfu/m were 72% and 71%, respectively. CONCLUSION: The combination of GRAM stain test and quantitative cultures of the endotracheal aspirates may contribute to the diagnostic evaluation of VAP |
| Portuguese abstract | CONCLUSÃO: A combinação do GRAM com a cultura quantitativa do aspirado traqueal pode contribuir para a avaliação diagnóstica da PAV |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Microbiología, Neumología, Neumonía, Respiración artificial, Lavado broncoalveolar, Bacteriología |
| Keyword: | Medicine, Diagnosis, Microbiology, Pneumology, Pneumonia, Artificial respiration, Bronchoalveolar lavage, Bacteriology |
| Full text: | Texto completo (Ver HTML) |
