Comparison between some techniques used for early detection of ventilator-associated infection

Abstract

Background Although mechanical ventilation could be lifesaving, yet it could be the cause of death owing to its complications. One of the reasons of death is the infection being challenging to the clinicians to diagnose owing to the clinical variability and a wide scale of diseases causing fever and chest infiltrates. The earlier the established diagnosis and proper therapy, the better the outcome. The objective was to compare between different methods used for the early diagnosis of ventilator-associated infection. Patients and methods The study included 50 patients mechanically ventilated for 72 h. The patients were subjected to basic clinical data collection, laboratory investigations, chest radiography, endotracheal aspiration (ETA), and bronchoalveolar lavage (BAL). Direct Gram stain and bacterial culture were done for both the aspirate and the lavage fluid. Results and conclusion A total of 27 patients were found to be infected. Agreement between direct Gram staining and bacterial culture of ETA was recorded in 64% of the cases, whereas the agreement with BAL was recorded in 76%. Overall agreement between ETA and BAL culture results was seen in 44%. From the previous results, ETA should not replace BAL as a diagnostic modality.

Keywords

• bacterial culture
• bronchoalveolar lavage
• endotracheal aspirate
• Gram stain
• ventilator-associated infection