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Title: Quantitative cultures of protected brush specimens and bronchoalveolar lavage in ventilated patients without suspected pneumonia
Authors: Rodríguez De Castro, Felipe 
Sole Violan, Jorge 
Elcuaz, Rosa
UNESCO Clasification: 32 Ciencias médicas
3201 Ciencias clínicas
Keywords: Bronchoalveolar lavage
Mechanically ventilated patients
Issue Date: 1994
Journal: American Journal of Respiratory and Critical Care Medicine 
Abstract: Quantitative bacterial cultures of protected specimen brush (PSB) and bronchoalveolar ravage (BAL) specimens were used to assess the presence of distal bronchial microflora in mechanically ventilated patients who were not suspected of having pneumonia. A total of 54 specimens from 32 ICU patients were obtained. In 10 patients, only PSB specimens were recovered, whereas in 22 patients both PSB and BAL specimens were obtained. Cultures demonstrated no growth in 10 (45%) of the 22 samples recovered by BAL and in 21 (66%) of the 32 samples recovered by the PSB method. Twenty-three specimens yielded microorganisms, but in only six patients was a significant growth in PSB and/or BAL cultures (greater than or equal to 10(3) and greater than or equal to 10(5) cfu/ml, respectively) detected. Four of these patients developed pneumonia on subsequent follow-up. In mechanically ventilated patients, the diagnostic thresholds of bacterial growth in PSB and BAL cultures may be misleading. A significant relationship was found between the ability of PSB to recover microorganisms and the duration of mechanical ventilation (p < 0.05). These findings may be a limitation present in all patients receiving prolonged mechanical ventilation.
ISSN: 1073-449X
Source: American Journal of Respiratory and Critical Care Medicine[ISSN 1073-449X],v. 149, p. 320-323
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