DETECTION OF BACTERIA CAUSES  VENTILATOR ASSOCIATED PNEUMONIA WITH  BRONCHOALVEOLAR  LAVAGE  CULTURE AND ENDOTRACHEAL ASPIRATE CULTURE

Ventilator associated pneumonia (VAP) is the most common hospital infection in ICU. Proper and prompt diagnosis and treatment with adequate antibiotics can reduce the high mortality rate, and prevent complications and antibiotic resistance. Invasive methods, such as bronchoalveolar lavage can make a more accurate diagnosis and help with the choice of antibiotics, but require lung experts. While non-invasive methods, such as endotracheal aspirate can be done faster with less complications. The aim of the study was to determine the pattern of bacterial and bacterial sensitivity to bronchoalveolar lavage and endotracheal fluid. This was an observational study with cross-sectional approaches performed at the Intensive Care Unit of RSUP H. Adam Malik Medan, in August 2017 - February 2018. The sample of 23 patients who met the criteria and was suspected with VAP was carried out by taking endotracheal aspirate and bronchoalveolar lavage. The samples obtained were culture and sensitivity test using BD Phoenix. There was bacteria pattern had compatibility at moderate levels and there was sensitivity and antibiotic resistance were not significantly different from bronchoalveolar cultures and endotracheal aspirate cultures. Endotracheal aspirate culture has a sensitivity of 78.9% and a specificity of 75% for diagnose VAP. Information on the identification of bacteria and sensitivity testing in patients with suspected VAP is required using appropriate sampling techniques. There were no significant differences between bronchoalveolar lavage culture and endotracheal aspirate culture to diagnosing VAP. Endotracheal aspirate culture is a non invasive diagnostic tool that can be used as an alternative diagnostic tool in patients with suspected VAP.

Download Full-text

Emergence of Alveolar Consolidations in Serial Lung Ultrasound and Diagnosis of Ventilator-Associated Pneumonia

Journal of Intensive Care Medicine ◽

10.1177/0885066619894279 ◽

2019 ◽

pp. 088506661989427 ◽

Cited By ~ 1

Author(s):

Leonardo Jönck Staub ◽

Roberta Rodolfo Mazzali Biscaro ◽

Rosemeri Maurici

Keyword(s):

Mechanical Ventilation ◽

Confidence Interval ◽

Diagnostic Tool ◽

Lung Ultrasound ◽

Lung Parenchyma ◽

Diagnostic Value ◽

Clinical Suspicion ◽

Ventilator Associated Pneumonia ◽

Endotracheal Aspirate

Background: Lung ultrasound (LUS) has been reported as a promising diagnostic tool for ventilator-associated pneumonia (VAP), but patients with previous lung parenchyma commitment have been not studied. Purpose: To evaluate whether the emergence of sonographic consolidations, rather than their presence, can improve the VAP diagnosis in a sample including patients with previous lung parenchyma diseases. Methods: Patients who completed 48 hours of mechanical ventilation were prospectively studied with daily LUS examinations. We checked the emergence of different consolidation types on the eve and on the day of a clinical suspicion of VAP. We elaborated an algorithm considering, sequentially, the emergence of (1) subpleural consolidations in anterior lung regions on the eve of suspicion; (2) lobar/sublobar consolidation in anterior lung regions on the day of suspicion; (3) lobar/sublobar consolidation with dynamic air bronchograms on the day of suspicion; and (4) any other lobar/sublobar consolidation on the day of suspicion in association with a positive Gram smear of endotracheal aspirate. Results: Of the 188 included patients, 60 were suspected and 33 confirmed VAP. The presence of sonographic consolidations at the clinical suspicion had no diagnostic value for VAP. The emergence of subpleural consolidations in anterior lung regions on the eve of suspicion had specificity of 95% (95% confidence interval [CI], 79%-99%). The emergence of lobar/sublobar consolidations in anterior lung regions on the day of suspicion had specificity of 100% (95% CI, 87%-100%). The emergence of lobar/sublobar consolidations with dynamic air bronchograms on the day of suspicion had specificity of 96% (95% CI, 81%-99%). Finally, the proposed algorithm had sensitivity of 63% (95% CI, 46%-77%) and specificity of 85% (95% CI, 67%-94%) for VAP. Conclusions: The presence of sonographic consolidations was not accurate for VAP when patients with previous lung parenchyma commitment were included. However, serial LUS examinations detected the emergence of specific signs of VAP.

Download Full-text

The efficiency of routine endotracheal aspirate cultures compared to bronchoalveolar lavage cultures in ventilator-associated pneumonia diagnosis

Nigerian Journal of Clinical Practice ◽

10.4103/1119-3077.164327 ◽

2016 ◽

Vol 19 (1) ◽

pp. 46 ◽

Cited By ~ 4

Author(s):

AH Tezcan ◽

H Yagmurdur ◽

O Karakurt ◽

F Leblebici

Keyword(s):

Bronchoalveolar Lavage ◽

Ventilator Associated Pneumonia ◽

Endotracheal Aspirate ◽

Pneumonia Diagnosis

Download Full-text

The Role of Musculoskeletal USG as Diagonostic Tool of CTS

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-25-2-44 ◽

2014 ◽

Vol 25 (2) ◽

pp. 44-49

Author(s):

P Das ◽

R Pramanik ◽

M Kataruka ◽

RN Haldar ◽

S Samanta ◽

...

Keyword(s):

Diagnostic Tool ◽

Predictive Value ◽

Low Cost ◽

Large Population ◽

Study Data ◽

Cross Sectional ◽

Non Invasive ◽

Invasive Test ◽

Kappa Value

Abstract Introduction Over the years NCS has been used to diagnose and monitor the patients with CTS though USG has several advantages as diagnostic tool. This study has been done to find out the diagnostic accuracy of USG in CTS and to compare the efficacy of USG with standard NCS in CTS. Prospective cross-sectional analytical study was conducted at Dept. of PM&R, IPGME&R, Kolkata from 1st March, 2012 to 31st August 2012 (6 months). Patient with clinical diagnosis of CTS of age >18 year of both sexes were included in this study and on the other hand patient with previous wrist surgery /injury, wrist deformity, diabetes mellitus, anatomical variants of median nerve on ultrasound were excluded from the study. Methodology After getting institutional ethical committee clearance, all patients who fulfil the above criteria were included in the study and further diagnostic conformation done by the standard diagnostic criteria of NCS. The same group of patients have been also screened by ultrasonography (USG). Results At the end of the study, data analysis showed that sensitivity and specificity were 92.3 and 70.0% respectively. Predictive value of +test, predictive value of -test were 88.9 and 77.8% respectively. Kappa value was 0.64 (between 0.5 and 0.7). It signifies that there is good correlation between NCS and USG as diagnostic tool of CTS. The comparison of the numerical values of median latency, amplitude and CSA USG within the groups with the help of ANOVA followed by Tukey's test showed that there was good correlation between latency and amplitude in mild, moderate, severe and profound CTS but unfortunately it was not correlated with the CSA measured by USG. Conclusion USG can be used for screening large population of patients as it is simple, easily available, non-invasive test and has relatively low cost and useful in evaluating and excluding local causes of nerve compression.

Download Full-text

Nonbronchoscopic bronchoalveolar lavage: A diagnostic tool for ventilator-associated pneumonia

American Journal of Infection Control ◽

10.1016/j.ajic.2005.04.172 ◽

2005 ◽

Vol 33 (5) ◽

pp. e136-e137

Author(s):

P. Kulich ◽

L. Ayers ◽

A. Gerlach ◽

T. Dunlea

Keyword(s):

Bronchoalveolar Lavage ◽

Diagnostic Tool ◽

Ventilator Associated Pneumonia

Download Full-text

Endotracheal Aspirate and Bronchoalveolar Lavage Fluid Analysis: Interchangeable Diagnostic Modalities in Suspected Ventilator-Associated Pneumonia?

Journal of Clinical Microbiology ◽

10.1128/jcm.01494-14 ◽

2014 ◽

Vol 52 (10) ◽

pp. 3597-3604 ◽

Cited By ~ 19

Author(s):

J. B. J. Scholte ◽

H. A. van Dessel ◽

C. F. M. Linssen ◽

D. C. J. J. Bergmans ◽

P. H. M. Savelkoul ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Bronchoalveolar Lavage Fluid ◽

Lavage Fluid ◽

Ventilator Associated Pneumonia ◽

Endotracheal Aspirate ◽

Fluid Analysis ◽

Diagnostic Modalities

Download Full-text

Role of quantitative endotracheal aspirate and cultures as a surveillance and diagnostic tool for ventilator associated pneumonia: A pilot study

Indian Journal of Medical Sciences ◽

10.4103/0019-5359.42187 ◽

2008 ◽

Vol 62 (8) ◽

pp. 304 ◽

Cited By ~ 12

Author(s):

JohnVictor Peter ◽

JohnPrakash Raj ◽

KN Brahmadathan ◽

Shalini Nair ◽

Nagamani Sen

Keyword(s):

Pilot Study ◽

Diagnostic Tool ◽

Ventilator Associated Pneumonia ◽

Endotracheal Aspirate

Download Full-text

Spectrum of Bacterial Co-Infections of the Lower Respiratory Tract in COVID 19 Patients Admitted to the ICU of a Tertiary Care Hospital

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1831060 ◽

2021 ◽

pp. 99-109

Author(s):

Shoaib Khan ◽

Asifa Nazir ◽

Humaira Bashir ◽

Umara Amin

Keyword(s):

Staphylococcus Aureus ◽

Respiratory Tract ◽

Bronchoalveolar Lavage ◽

Lower Respiratory Tract ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Rt Pcr ◽

Endotracheal Aspirate ◽

Cross Sectional

Aims: We aimed to evaluate the burden of bacterial co-infections in patients with COVID-19 and to ensure judicious use of antibiotics. Study Design: Hospital based, cross sectional study. Place and Duration of Study: Postgraduate department of Microbiology, Government Medical College, Srinagar, and associated hospitals, between July 2020 and February 2021. Methodology: A total of 70 patients diagnosed with COVID-19 by RT PCR of nasopharyngeal/oropharyngeal samples were included in the study. Lower respiratory specimen like endotracheal aspirate (ETA), sputum, and bronchoalveolar lavage (BAL) from COVID-19 patients admitted in the ICU were collected as per standard protocol and subjected to quantitative cultures in the laboratory. Antimicrobial susceptibility testing was carried out in line with CLSI recommendations. Results: Of the 70 lower respiratory tract specimens (Endotracheal aspirate n=53, sputum n=15, and Bronchoalveolar lavage n=02) taken from RT-PCR confirmed COVID-19 patients, 51 (72.9%) showed microbiological evidence of bacterial infection by culture positivity. 28/51 (55%) were males and 23/51 (45%) were females, mean age was 54 years (range= 16-85 years). Majority of the organisms recovered (n=51, 83%) were Gram-negative bacilli, among which Acinetobacter spp. (n=27, 53%) followed by Klebsiella pneumoniae (n=06, 12%) were the most common. Among Gram positive organisms, methicillin resistant Staphylococcus aureus and Enterococcus sp were most commonly isolated. Conclusion: It is evident from our study that superinfection in COVID-19 patients due to Acinetobacter baumannii and Staphylococcus aureus is of serious concern. Timely treatment of these infections is pivotal to decrease the morbidity and mortality rates in COVID-19-infected patients.

Download Full-text

Salivary creatinine as a diagnostic tool for evaluating patients with chronic kidney disease

BMC Nephrology ◽

10.1186/s12882-019-1546-0 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Dada Oluwaseyi Temilola ◽

Karla Bezuidenhout ◽

Rajiv Timothy Erasmus ◽

Lawrence Stephen ◽

Mogamat Razeen Davids ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Diagnostic Tool ◽

Linear Regression Analysis ◽

Strong Positive Correlation ◽

Western Cape ◽

Operating Characteristics ◽

Creatinine Concentration ◽

Cross Sectional ◽

Non Invasive

Abstract Background Preliminary studies have shown the potential use of salivary creatinine concentration in the diagnosis of chronic kidney disease (CKD). For saliva to replace serum as a diagnostic tool, studies must be done to determine its effectiveness in the diagnosis and staging of CKD. The aim of the present study was to evaluate the use of salivary creatinine as a safe and non-invasive alternative for identifying patients with CKD. Methods A cross-sectional study was conducted at Tygerberg Hospital in Cape Town, on 230 patients, across all stages of CKD. Ethical approval to conduct the study was obtained from the University of the Western Cape Biomedical Research Ethics Committee, and written informed consent was provided by each participant. Saliva and serum samples were collected for creatinine analysis and the correlation determined using Spearman’s correlation. Receiver operating characteristics (ROC) analysis was used to determine the diagnostic ability of salivary creatinine. A cut-off value for optimal sensitivity and specificity of salivary creatinine to diagnose CKD with glomerular filtration rate (GFR) < 60 mL/min/1.73 m2 was obtained. Results Serum creatinine values ranged from 46 μmol/L to 1581 μmol/L, with a median value of 134 μmol/L. Salivary creatinine values ranged from 3 μmol/L to 400 μmol/L, with a median of 11 μmol/L. There was a strong positive correlation (r = 0.82) between serum and salivary creatinine values. Linear regression analysis of serum and salivary creatinine for CKD patients was significant in all CKD stages, except for stage 1. Area under the curve for salivary creatinine was 0.839. A cut-off value of 8.5 μmol/L yielded a sensitivity of 78.3% and specificity of 74.0% for classifying patients as having CKD based on estimated GFR < 60 mL/min/1.73 m2. Conclusions The results support the potential of salivary creatinine as a non-invasive diagnostic tool for estimating GFR and identifying patients with CKD.

Download Full-text