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KMID : 0191120110260070865
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Journal of Korean Medical Science
2011 Volume.26 No. 7 p.865 ~ p.869
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Usefulness of Quantitative Endotracheal Aspirate Cultures in Intensive Care Unit Patients with Suspected Pneumonia
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Shin Yoon-Mi
Oh Yeon-Mok
Kim Mi-Na
Shim Tae-Sun
Lim Chae-Man
Lee Sang-Do
Koh Youn-Suck
Kim Woo-Sung
Kim Dong-Soon
Hong Sang-Bum
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Abstract
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It is difficult to differentiate pathogens responsible for pneumonia or colonization in patients with an endotracheal tube or in patients that have undergone tracheostomy. We evaluated the clinical usefulness of quantitative endotracheal aspirates cultures and sought to determine the result threshold level for positivity. The authors performed this retrospective cohort study between December 1, 2004 and January 31, 2006. Forty-five suspected pneumonia patients admitted to an intensive care unit (ICU) with quantitative bronchoalveolar lavage (BAL) and endotracheal aspirate (EA) culture results were enrolled. Using a threshold of 105 cfu/mL, 10 of the 45 (22.2%) quantitative EA cultures were positive, as compared with 7 (15.6%) BAL cultures. When BAL culture findings were used as the reference, the sensitivity and specificity of quantitative EA cultures were 85.7% and 89.5%, respectively, at a threshold of 105 cfu/mL, and 85.7% and 94.7%, respectively, at a threshold of 106 cfu/mL. Of the 10 EA culture positive patients, 2 patients with a result of -105 cfu/mL were BAL culture negative. The quantitative EA culture is a useful non-invasive tool for the diagnosis of pneumonia pathogens. It is suggested that a threshold level of 106 cfu/mL is appropriate.
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KEYWORD
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Quantitative Culture, Endotracheal Aspirate, Pneumonia
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