Role of Microbiologic Culture Results of Specimens Prior to Onset of Ventilator-Associated Pneumonia in the Patients Admitted to Intensive Care Unit.
- Author:
Ji Hye KIM
1
;
Sung Chul YOON
;
Yu Mi LEE
;
Ji Woong SON
;
Eu Gene CHOI
;
Moon Jun NA
;
Sun Jung KWON
Author Information
- Publication Type:Original Article
- Keywords: Pneumonia, Ventilator-Associated; Bronchoalveolar Lavage; Anti-Bacterial Agents
- MeSH: Anti-Bacterial Agents; Bronchoalveolar Lavage; Bronchoscopy; Humans; Critical Care; Intensive Care Units; Klebsiella; Methicillin-Resistant Staphylococcus aureus; Pneumonia; Pneumonia, Ventilator-Associated; Stenotrophomonas maltophilia
- From:Tuberculosis and Respiratory Diseases 2012;72(1):30-36
- CountryRepublic of Korea
- Language:Korean
- 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. 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.
