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Intensive Care Med Exp. 2015 December; 3(Suppl 1): A711.
Published online 2015 October 1. doi:  10.1186/2197-425X-3-S1-A711
PMCID: PMC4796244

The usefulness of non-directed bronchoalveolar lavage in diagnosis pneumonia in ICU

Introduction

Intensive care units are high-risk areas for infections caused by antibiotic-resistant bacteria. Care of ICUs patients involve close contact with hospital staff and provide opportunities for cross-contamination from the environment and from other patients. The resulting colonization of patients is generally accepted as a prerequisite for causing most of nosocomial infections including hospital - aquired pneumonia and VAP. Information about microorganism which cause particular infections and colonization in ICU is essential to prepare local antibiotic guidelines and should be taken into account in implementing empirical treatment.

Objectives

The aim of the study was to create ICU's microbiological map of pneumonia based on specimens received from non-directed bronchoalveolar lavage.

Methods

We analyzed the results of the non-directed bronchoalveolar lavage (NBL) collected from patients hospitalized in the ICU during last 5 years. Every patient admitted to the ICU had NBL taken and was categorized to one of three groups: no infection, colonization (colony forming< 102 units/mL), pneumonia (colony forming ≥103 units/mL). We analyzed the types of bacteria which caused colonization or pneumonia and their antibiotic-sensitivity.

Results

See tables tables1,1, ,22 and and3Table3

Table 1
Results of the NBL performed on the admission.
Table 2
Identification of microorganisms caused pneumonia.
Table 3
Antibiotic - sensitivity of A.baumani.

Conclusions

The NBL is a useful method to identify infection and colonization of lower airways. It allows to create microbiological map of ICU's residual pathogens and their drug sensitivity, and as a consequents gives intensivist opportunity to implement suitable antibiotic treatment.

Grant Acknowledgment

ICU Staff

References

1. UK Standards for Microbiology Investigations: Investigation of Bronchoalveolar Lavage, Sputum and associated Specimens. Bacteriology/B57/No.25/02.06.2014
2. Bhattacharya S, Mondal AS. Clinical microbiology in the intensive care unit: Strategic and operational characteristics. Indian J Med Microbiol. 2010;28(1):5–10. doi: 10.4103/0255-0857.58720. [PubMed] [Cross Ref]
3. Chastre J, Fagon JY. Invasive diagnostic testing should be routinely used to manage ventilated patients with suspected pneumonia. Am J Respir Crit Care Med. 1994;150:570–574. doi: 10.1164/ajrccm.150.2.8049850. [PubMed] [Cross Ref]
4. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia Am J Respir Crit Care Med. 2005;171:388–416. doi: 10.1164/rccm.200405-644ST. [PubMed] [Cross Ref]

Articles from Intensive Care Medicine Experimental are provided here courtesy of Springer-Verlag