Rodríguez de Castro F, Solé Violán J, Lafarga Capuz B, Caminero Luna J, González Rodríguez B, Manzano Alonso J L
Sección de Neumología, Hospital Ntra. Sra. del Pino, Canary Islands, Spain.
Crit Care Med. 1991 Feb;19(2):171-5. doi: 10.1097/00003246-199102000-00010.
To assess the usefulness of the telescoping plugged catheter in the diagnosis of nosocomial pneumonia.
Prospective study.
A total of 103 ventilated patients with suspected pneumonia were prospectively studied over 20 months.
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.
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.
评估可伸缩堵塞导管在医院获得性肺炎诊断中的实用性。
前瞻性研究。
对103例疑似肺炎的机械通气患者进行了为期20个月的前瞻性研究。
保护性毛刷标本的定量培养在49例（47.5%）患者中检测到肺部细菌感染（大于10³ cfu/mL）。随后的随访证实41例患者患有肺炎；仅1例患者的保护性毛刷标本培养阳性结果被确认为假阳性。54例患者的菌落形成单位数低于10³ cfu/mL，其中36例排除了肺炎诊断。我们发现8例患者的保护性毛刷标本培养结果为假阴性。该技术所得结果使我们能够对49例（47.5%）患者的治疗方案进行调整。
在怀疑有肺部细菌感染的患者中，可伸缩堵塞导管仅在相对较小比例的患者中检测到显著细菌感染。该技术操作安全，是一种用于确定肺炎病因的敏感且特异的方法，从而能够进行针对性治疗并避免不恰当的抗生素治疗。
