[不同支气管吸出物培养方法在呼吸机相关性肺炎（VAP）患者中的比较]
[The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia (VAP)].
作者信息
Kowalczyk Wojciech, Rybicki Zbigniew, Tomaszewski Dariusz, Truszczyński Andrzej, Guzek Aneta
机构信息
Department of Anaesthesiology and Intensive Therapy, Military Institute of Medicine in Warsaw,Warszawa.
出版信息
Anestezjol Intens Ter. 2011 Apr-Jun;43(2):74-9.
BACKGROUND
Although broncho-alveolar lavage (BAL) culture and protected specimen brush (PSB) are regarded as the most effective methods in the diagnosis of VAP, a simple endotracheal aspiration (EA) is frequently performed during routine care, because of its simplicity and low cost. We compared the effectiveness of EA with BAL and PSB in VAP patients.
METHODS
Sixty-one adult VAP patients, ventilated for longer than 48 h, were cultured with all three methods.
RESULTS
Positive cultures were obtained from 63.9% of patients, with Acinetobacter baumannii being the most common pathogen. There was a high positive correlation between simple aspirates and BAL (k 0.817, CI 0.664-0.840, p <0.001) and aspirates and PSB (k 0.667, CI 0.483-0.871, p <0.001).
CONCLUSION
Because of the high sensitivity of bronchial aspirate culturing, compared to BAL and PSB, it can be used successfully in most cases.
背景
尽管支气管肺泡灌洗（BAL）培养和防污染样本毛刷（PSB）被视为诊断呼吸机相关性肺炎（VAP）最有效的方法，但由于操作简单且成本低，在常规护理中经常进行简单的气管内抽吸（EA）。我们比较了EA与BAL和PSB在VAP患者中的有效性。
方法
对61例通气时间超过48小时的成年VAP患者采用这三种方法进行培养。
结果
63.9%的患者培养结果为阳性，鲍曼不动杆菌是最常见的病原体。简单抽吸物与BAL之间（κ 0.817，可信区间0.664 - 0.840，p <0.001）以及抽吸物与PSB之间（κ 0.667，可信区间0.483 - 0.871，p <0.001）存在高度正相关。
结论
与BAL和PSB相比，由于支气管抽吸物培养具有高敏感性，它在大多数情况下都能成功应用。
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