OBJECTIVE: To assess the usefulness of the telescoping plugged catheter in the diagnosis of nosocomial pneumonia. DESIGN: Prospective study. PATIENTS: A total of 103 ventilated patients with suspected pneumonia were prospectively studied over 20 months. RESULTS: The quantitative cultures of the protected brush specimen detected pulmonary bacterial infection (greater than 10(3) cfu/mL) in 49 (47.5%) patients. Subsequent follow-up confirmed pneumonia in 41 patients; in only one patient was a positive protected brush specimen culture established as a false-positive result. There were 54 patients with less than 10(3) cfu/mL and the diagnosis was excluded in 36 of them. We identified eight patients with false-negative protected brush specimen cultures. The results obtained by this technique allowed us to modify treatment in 49 (47.5%) patients. CONCLUSIONS: The telescoping plugged catheter demonstrated significant bacterial infection in a relatively small proportion of patients in whom bacterial lung infection was suspected. This technique can be safely performed and is a sensitive and specific method to establish the cause of pneumonia, thus allowing specific treatment and the avoidance of inappropriate antibiotic therapy.
OBJECTIVE: To assess the usefulness of the telescoping plugged catheter in the diagnosis of nosocomial pneumonia. DESIGN: Prospective study. PATIENTS: A total of 103 ventilated patients with suspected pneumonia were prospectively studied over 20 months. RESULTS: The quantitative cultures of the protected brush specimen detected pulmonary bacterial infection (greater than 10(3) cfu/mL) in 49 (47.5%) patients. Subsequent follow-up confirmed pneumonia in 41 patients; in only one patient was a positive protected brush specimen culture established as a false-positive result. There were 54 patients with less than 10(3) cfu/mL and the diagnosis was excluded in 36 of them. We identified eight patients with false-negative protected brush specimen cultures. The results obtained by this technique allowed us to modify treatment in 49 (47.5%) patients. CONCLUSIONS: The telescoping plugged catheter demonstrated significant bacterial infection in a relatively small proportion of patients in whom bacterial lung infection was suspected. This technique can be safely performed and is a sensitive and specific method to establish the cause of pneumonia, thus allowing specific treatment and the avoidance of inappropriate antibiotic therapy.
Authors: Alvaro Rea-Neto; Nazah Cherif M Youssef; Fabio Tuche; Frank Brunkhorst; V Marco Ranieri; Konrad Reinhart; Yasser Sakr Journal: Crit Care Date: 2008-04-21 Impact factor: 9.097