A simple method for diagnosing pneumonia in intubated or tracheostomized patients.

A safe, simple, reliable technique for sampling uncontaminated peripheral bronchial secretions in patients with endotracheal tubes has been developed. It is easily performed and requires no special training or equipment. This report summarizes the techniques's usefulness in providing diagnostic samples of peripheral airway secretions from 20 patients with pneumonic infiltrates. In eight of the patients, a single organism was recovered from the peripheral airway despite polymicrobial colonization of the upper airways. An additional patient had two anaerobes. The recovered organism's role as a pathogen was verified by an appropriate response to specific antibiotic therapy in two patients, isolation from blood or empyema fluid in five, confirmation by bronchoscopy in one, and transtracheal aspiration after extubation in one. Peripheral bronchial secretions were sterile in the remaining 11 patients, even though multiple organsims were isolated from usual tracheal suctionings.