Resp Care
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Comparative Study
Comparison of semi-quantitative endotracheal aspirates to quantitative non-bronchoscopic bronchoalveolar lavage in diagnosing ventilator-associated pneumonia.
Current strategies for diagnosing ventilator-associated pneumonia (VAP) favor the use of quantitative methods; however, semi-quantitative cultures of endotracheal aspirates are still commonly used. ⋯ Semi-quantitative cultures of endotracheal aspirate are poorly concordant with quantitative cultures obtained via non-bronchoscopic BAL. Although the performance of endotracheal aspirate improves when antibiotic treatment is considered, guiding therapy on the basis of semi-quantitative cultures may still result in failure to identify potentially multiple-drug-resistant pathogens, and would also tend to promote excessive antibiotic usage. Our data support the use of quantitative cultures in diagnosing VAP.