|
KMID : 0383820120720010030
|
|
Tuberculosis and Respiratory Diseases
2012 Volume.72 No. 1 p.30 ~ p.36
|
|
|
Role of Microbiologic Culture Results of Specimens Prior to Onset of Ventilator-Associated Pneumonia in the Patients Admitted to Intensive Care Unit
|
|
Kim Ji-Hye
Yun Seong-Cheol
Lee Yu-Mi
Son Ji-Woong
Choi Eu-Gene
Na Moon-Jun
Kwon Sun-Jung
|
|
|
Abstract
|
|
|
Background : Patients with ventilator-associated pneumonia (VAP) in intensive care unit (ICU) have a high mortality rate. The routine surveillance cultures obtained previously or an ATS guideline for hospital-acquired pneumonia was used in selecting initial antimicrobials. The object of this study was to compare the respiratory samples before VAP and bronchoalveolar lavage (BAL) culture.
Materials and Methods : 54 patients underwent fiberoptic bronchoscopy to obtain BAL samples. We reviewed microbiologic specimen results of prior respiratory specimens (pre-VAP) and BAL.
Results : Among 51 patients with 54 VAP episodes, 52 microorganisms of pre-VAP and 56 BAL samples were isolated. Pre-VAP included 21.2% of MRSA, and 32.6% of multidrug resistant-Acinetobacter baumannii (MDR-AB). BAL samples comprised 25.0% of MRSA, 26.7% of MDR-AB, 14.3% of Stenotrophomonas maltophilia and 3.6% of Klebsiella pneumonia in order. In pre-VAP samples compared to BAL samples, only 35.2% were identical. In BAL samples compared to pre-VAP samples obtained in 5 days before the onset of VAP, only 43.6% were identical. However, among BAL samples compared to pre-VAP samples obtained after more than 5 days, 13.3% were identical (p=0.037).
Conclusion : Based on these data, pre-VAP samples obtained prior to 5 day onset of VAP may help to predict the causative microorganisms and to select appropriate initial antimicrobials.
|
|
|
KEYWORD
|
|
|
Pneumonia, Ventilator-Associated, Bronchoalveolar Lavage, Anti-Bacterial Agents
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|