Abstract
Background: The presence of intracellular organisms (ICOs) in polymorphonuclear cells obtained from respiratory secretions is a possible method for rapid diagnosis of ventilator-associated pneumonia. We correlated ICOs with quantitative endotracheal aspirate (QA) in intubated patients. Methods: Consecutive intubated patients in the surgical intensive care unit had respiratory samples obtained every 2 days until extubation. Two thresholds for ICOs and quantitative culture were examined. Sensitivity, specificity, and positive and negative predictive values were calculated using QA as reference. Results: One hundred one samples were obtained from 35 patients. Colony counts ≥ 100,000 were found in 34 samples; 60 samples had colony counts ≥ 10,000. Antibiotic use did not affect the sensitivity or specificity of ICOs. Sensitivity of ICOs was 39% to 85%, and specificity was 82 % to 97 %. Positive predictive value was 70% to 96%, and negative predictive value was 50% to 91%. Conclusion: ICOs provide a quick method for establishing the presence of a significant bacterial load in the respiratory tract. Accuracy of ICOs in predicting a positive QA is not affected by concurrent antibiotics.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 141-146 |
| Number of pages | 6 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 54 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2003 |
| Externally published | Yes |
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Keywords
- Intracellular organisms
- Quantitative culture
- Ventilator-associated pneumonia
ASJC Scopus subject areas
- Surgery
Cite this
Correlation of intracellular organisms with quantitative endotracheal aspirate. / Brasel, Karen; Allen, Brian; Edmiston, Chuck; Weigelt, John A.; Franklin, Glen A.; Malangoni, Mark A.; West, Michael A.; Schermer, Carol R.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 54, No. 1, 01.01.2003, p. 141-146.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Correlation of intracellular organisms with quantitative endotracheal aspirate
AU - Brasel, Karen
AU - Allen, Brian
AU - Edmiston, Chuck
AU - Weigelt, John A.
AU - Franklin, Glen A.
AU - Malangoni, Mark A.
AU - West, Michael A.
AU - Schermer, Carol R.
PY - 2003/1/1
Y1 - 2003/1/1
N2 - Background: The presence of intracellular organisms (ICOs) in polymorphonuclear cells obtained from respiratory secretions is a possible method for rapid diagnosis of ventilator-associated pneumonia. We correlated ICOs with quantitative endotracheal aspirate (QA) in intubated patients. Methods: Consecutive intubated patients in the surgical intensive care unit had respiratory samples obtained every 2 days until extubation. Two thresholds for ICOs and quantitative culture were examined. Sensitivity, specificity, and positive and negative predictive values were calculated using QA as reference. Results: One hundred one samples were obtained from 35 patients. Colony counts ≥ 100,000 were found in 34 samples; 60 samples had colony counts ≥ 10,000. Antibiotic use did not affect the sensitivity or specificity of ICOs. Sensitivity of ICOs was 39% to 85%, and specificity was 82 % to 97 %. Positive predictive value was 70% to 96%, and negative predictive value was 50% to 91%. Conclusion: ICOs provide a quick method for establishing the presence of a significant bacterial load in the respiratory tract. Accuracy of ICOs in predicting a positive QA is not affected by concurrent antibiotics.
AB - Background: The presence of intracellular organisms (ICOs) in polymorphonuclear cells obtained from respiratory secretions is a possible method for rapid diagnosis of ventilator-associated pneumonia. We correlated ICOs with quantitative endotracheal aspirate (QA) in intubated patients. Methods: Consecutive intubated patients in the surgical intensive care unit had respiratory samples obtained every 2 days until extubation. Two thresholds for ICOs and quantitative culture were examined. Sensitivity, specificity, and positive and negative predictive values were calculated using QA as reference. Results: One hundred one samples were obtained from 35 patients. Colony counts ≥ 100,000 were found in 34 samples; 60 samples had colony counts ≥ 10,000. Antibiotic use did not affect the sensitivity or specificity of ICOs. Sensitivity of ICOs was 39% to 85%, and specificity was 82 % to 97 %. Positive predictive value was 70% to 96%, and negative predictive value was 50% to 91%. Conclusion: ICOs provide a quick method for establishing the presence of a significant bacterial load in the respiratory tract. Accuracy of ICOs in predicting a positive QA is not affected by concurrent antibiotics.
KW - Intracellular organisms
KW - Quantitative culture
KW - Ventilator-associated pneumonia
UR - http://www.scopus.com/inward/record.url?scp=0037242254&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037242254&partnerID=8YFLogxK
U2 - 10.1097/00005373-200301000-00017
DO - 10.1097/00005373-200301000-00017
M3 - Article
C2 - 12544909
AN - SCOPUS:0037242254
VL - 54
SP - 141
EP - 146
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 1
ER -