Chinese Med J Peking
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Chinese Med J Peking · Jan 2014
Multicenter StudyMicroscopic examination of intracellular organisms in bronchoalveolar lavage fluid for the diagnosis of ventilator-associated pneumonia: a prospective multi-center study.
The presence of intracellular organisms (ICOs) in polymorphonuclear leukocytes obtained from bronchoalveolar lavage fluid (BALF) is a possible method for rapid diagnosis of ventilator-associated pneumonia (VAP). However, the validity of this diagnostic method remains controversial and the diagnostic thresholds reported by investigators were different. Our objective was to evaluate the accuracy of quantification of ICOs in BALF for the diagnosis of VAP, and to detect the best cutoff percentage of PMNs containing ICOs (PIC) in the microscopic examination of BALF for the diagnosis of VAP. ⋯ PIC>1.5% has good diagnostic performance in the microscopic examination of BALF for the diagnosis of VAP. However, Gram's stain is not reliable for the early application of antibiotic therapy, due to the poor bacteriological predictive value.