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http://dx.doi.org/10.4046/trd.2012.72.1.30

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 (Department of Internal Medicine, Konyang University College of Medicine)
Yoon, Sung-Chul (Department of Internal Medicine, Konyang University College of Medicine)
Lee, Yu-Mi (Department of Internal Medicine, Konyang University College of Medicine)
Son, Ji-Woong (Department of Internal Medicine, Konyang University College of Medicine)
Choi, Eu-Gene (Department of Internal Medicine, Konyang University College of Medicine)
Na, Moon-Jun (Department of Internal Medicine, Konyang University College of Medicine)
Kwon, Sun-Jung (Department of Internal Medicine, Konyang University College of Medicine)
Publication Information
Tuberculosis and Respiratory Diseases / v.72, no.1, 2012 , pp. 30-36 More about this Journal
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.
Keywords
Pneumonia, Ventilator-Associated; Bronchoalveolar Lavage; Anti-Bacterial Agents;
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