Correlation of intracellular organisms with quantitative endotracheal aspirate. J Trauma 2003 Jan;54(1):141-4; discussion 144-6
Date
01/25/2003Pubmed ID
12544909DOI
10.1097/00005373-200301000-00017Scopus ID
2-s2.0-0037242254 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
BACKGROUND: The presence of intracellular organisms (ICOs) in polymorphonuclear cells obtained from respiratory secretions is a possible method for rapid diagnosis of ventilator-associated pneumonia. We correlated ICOs with quantitative endotracheal aspirate (QA) in intubated patients.
METHODS: Consecutive intubated patients in the surgical intensive care unit had respiratory samples obtained every 2 days until extubation. Two thresholds for ICOs and quantitative culture were examined. Sensitivity, specificity, and positive and negative predictive values were calculated using QA as reference.
RESULTS: One hundred one samples were obtained from 35 patients. Colony counts >or= 100,000 were found in 34 samples; 60 samples had colony counts >or= 10,000. Antibiotic use did not affect the sensitivity or specificity of ICOs. Sensitivity of ICOs was 39% to 85%, and specificity was 82% to 97%. Positive predictive value was 70% to 96%, and negative predictive value was 50% to 91%.
CONCLUSION: ICOs provide a quick method for establishing the presence of a significant bacterial load in the respiratory tract. Accuracy of ICOs in predicting a positive QA is not affected by concurrent antibiotics.
Author List
Brasel KJ, Allen B, Edmiston C, Weigelt JAMESH terms used to index this publication - Major topics in bold
Anti-Bacterial AgentsBronchoalveolar Lavage Fluid
Colony Count, Microbial
Cross Infection
Female
Humans
Intracellular Fluid
Male
Neutrophils
Pneumonia, Bacterial
ROC Curve
Sensitivity and Specificity
Sputum
Suction
Time Factors
Ventilators, Mechanical
