Azam Abdul Rehman, Haidri Fakhir Raza, Nadeem Ali, Imran Sumera, Arain Nazia, Fahim Maheen
Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.
IJID Reg. 2024 Dec 16;14:100518. doi: 10.1016/j.ijregi.2024.100518. eCollection 2025 Mar.
Pneumonia is a major cause of morbidity and mortality among patients in the intensive care unit (ICU). Timely and accurate diagnosis is crucial for effective treatment, but lower respiratory tract sampling techniques vary in sensitivity and specificity. This study aims to compare the diagnostic accuracy of endotracheal aspirate (ETA) with mini bronchoalveolar lavage (mBAL) in detecting bacterial pneumonia in intubated patients, assessing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ETA against mBAL, the gold standard.
A cross-sectional comparative study was conducted at the ICU of Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan, over 7 months. Adult patients on mechanical ventilation with suspected or confirmed pneumonia were included. Both mBAL and ETA samples were collected under strict aseptic conditions.
Out of 120 patients, 112 paired samples were analyzed. ETA exhibited a sensitivity of 81.1%, specificity of 92.1%, PPV of 95.2%, and NPV of 71.4%, with an overall accuracy of 84.8%. The most commonly isolated pathogens were and . No serious adverse events occurred.
ETA is a cost-effective and reliable alternative to mBAL for diagnosing bacterial pneumonia in intubated ICU patients, but clinicians should carefully interpret negative results.
肺炎是重症监护病房（ICU）患者发病和死亡的主要原因。及时准确的诊断对有效治疗至关重要，但下呼吸道采样技术的敏感性和特异性各不相同。本研究旨在比较气管内吸出物（ETA）与微型支气管肺泡灌洗（mBAL）在检测插管患者细菌性肺炎方面的诊断准确性，评估ETA相对于金标准mBAL的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
在巴基斯坦卡拉奇的信德泌尿与移植研究所（SIUT）的ICU进行了一项为期7个月的横断面比较研究。纳入疑似或确诊肺炎的机械通气成年患者。mBAL和ETA样本均在严格无菌条件下采集。
120例患者中，分析了112对样本。ETA的敏感性为81.1%，特异性为92.1%，PPV为95.2%，NPV为71.4%，总体准确率为84.8%。最常分离出的病原体是[此处原文缺失病原体名称]和[此处原文缺失病原体名称]。未发生严重不良事件。
对于诊断插管ICU患者的细菌性肺炎，ETA是一种经济有效且可靠的替代mBAL的方法，但临床医生应谨慎解读阴性结果。
