机械通气患者气管内吸引物和气管内导管培养的微生物分析。

Microbiological analysis of endotracheal aspirate and endotracheal tube cultures in mechanically ventilated patients.

机构信息

Department of Clinical Laboratory, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, No.1, Chengbei Rd, Jiading District, Shanghai, 201800, China.

Department of Critical Care Medicine, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, 201800, China.

出版信息

BMC Pulm Med. 2019 Aug 27;19(1):162. doi: 10.1186/s12890-019-0926-3.

DOI:10.1186/s12890-019-0926-3

PMID:31455270

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6712863/

Abstract

BACKGROUND

To compare the microbiological culture within endotracheal aspirate specimens (ETAs) and endotracheal tube specimens (ETTs) in patients undergoing mechanical ventilation (MV) by statistical tools.

METHOD

ETAs and ETTs from a total number of 81 patients, who were undergoing MV at the intensive care unit (ICU) of Jiading Central Hospital Affiliated Shanghai University of Medicine & Health Sciences from September 1st, 2017 to August 31st, 2018, were collected for microbiological culture analysis. Correlation of ETAs and ETTs cultures were obtained by Spear-men correlation analysis, while the consistency of the two specimens was determined by Kappa analysis and principal component analysis (PCA).

RESULTS

Microbiological culture from both ETAs and ETTs showed that Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens, with Spear-man correlation coefficients of 0.676, 0.951, 0.730 and 0.687 respectively (all P < 0.01), and the overall Spear-man correlation coefficient is 0.757 (P < 0.01). This result shows that two samples were positively correlated. Kappa analysis also revealed high consistency of the microbial culture results from the ETAs and the ETTs (overall κ = 0.751, P < 0.01). The κ values for the four bacteria detected were 0.670, 0.949, 0.723, and 0.687, respectively (all P < 0.001). PCA also revealed high similarity.

CONCLUSION

Combining microbiological culture and statistical analysis of samples collected from 81 patients who were undergoing MV in ICU, we showed that microbe found in the ETAs had high similarity with that found in the ETTs which collected at the end of the catheters. In clinical practice, ETAs analysis is easily accessible meanwhile provides a valuable information for MV patients.

摘要

背景

通过统计工具比较机械通气（MV）患者的气管内吸出物标本（ETA）和气管内导管标本（ETT）中的微生物培养情况。

方法

2017 年 9 月 1 日至 2018 年 8 月 31 日，从上海大学附属嘉定中心医院重症监护病房（ICU）接受 MV 的 81 名患者中采集 ETA 和 ETT 进行微生物培养分析。采用 Spearman 相关分析获得 ETA 和 ETT 培养物的相关性，通过 Kappa 分析和主成分分析（PCA）确定两种标本的一致性。

结果

ETA 和 ETT 的微生物培养均显示鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌和肺炎克雷伯菌是主要病原体，Spearman 相关系数分别为 0.676、0.951、0.730 和 0.687（均 P<0.01），总 Spearman 相关系数为 0.757（P<0.01）。这表明两个样本呈正相关。Kappa 分析也显示 ETA 和 ETT 的微生物培养结果具有高度一致性（总κ=0.751，P<0.01）。四种细菌的κ值分别为 0.670、0.949、0.723 和 0.687（均 P<0.001）。PCA 也显示出高度相似性。