Quantitative culture of endotracheal aspirate in respiratory ICU

Abstract

Background Ventilator-associated pneumonia (VAP) is considered a frequent nosocomial complication in intensive care, and it remains a common cause of prolonged hospital stay and death, although there is improvement in diagnosis and therapy. Aim The aim of this study was to detect the type of organism and prevelance of VAP in the respiratory ICUs at Ain Shams University Hospital. Patients and methods A total of 50 patients connected to mechanical ventilation were selected for serial chest radiography, total leukocytic count, and quantitative endotracheal aspirate culture to diagnose new invading tracheobronchial organisms. Results We found direct relation between bypassing of oropharyngeal commensal, invasion of tracheobroncial tree by new microorganisms, and the duration of mechanical ventilation. The percentage of Acinetobacter baumannii was 25.8%, whereas it was 19.3% for Staphylococcus aureus, 16.1% for Pseudomonas aeruginosa, 9.67% for Haemophilus influenza, and 6.4% for each Proteus mirabilis and Citrobacter freundii. Conclusion VAP is a serious problem that leads to high costs in treatment, longer hospital stay, and high rate of mortality and morbidity. Long time of mechanical ventilation is a causative factor. A. baumannii and S. aureus were the most common germs in endotracheal aspirate cultures.

Keywords

• endotracheal aspirate
• hospital stay
• quantitative culture
• respiratory ICU
• VAP