Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/196820 |
Resumo: | Background: The Gram stain can be used to direct initial empiric antimicrobial therapy when complete culture is not available. This rapid test could prevent the initiation of inappropriate therapy and adverse outcomes. However, several studies have attempted to determine the value of the Gram stain in the diagnosis and therapy of bacterial infection in different populations of patients with ventilator-associated pneumonia (VAP) with conflicting results. The objective of this study is to evaluate the accuracy of the Gram stain in predicting the existence of Staphylococcus aureus infections from cultures of patients suspected of having VAP. Methods: This prospective single-center open cohort study enrolled 399 patients from December 2005 to December 2010. Patients suspected of having VAP by ATS IDSA criteria were included. Respiratory secretion samples were collected by tracheal aspirate (TA) for standard bacterioscopic analysis by Gram stain and culture. Results: Respiratory secretion samples collected by tracheal aspirates of 392 patients were analyzed by Gram stain and culture. When Gram-positive cocci were arranged in clusters, the sensitivity was 68.4%, specificity 97.8%, positive predictive value 88.1% and negative predictive value 92.8% for predicting the presence of Staphylococcus aureus in culture (p < 0.001). Conclusions: A tracheal aspirate Gram stain can be used to rule out the presence of Staphylococcus aureus in patients with a clinical diagnosis of VAP with a 92.8% Negative Predictive Value. Therefore, 7.2% of patients with Staphylococcus aureus would not be protected by an empiric treatment that limits antimicrobial coverage to Staphylococcus aureus only when Gram positive cocci in clusters are identified. |
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Seligman, RenatoSeligman, Beatriz Graeff SantosKonkewicz, Loriane RitaSantos, Rodrigo Pires dos2019-07-12T02:35:59Z20151471-2253http://hdl.handle.net/10183/196820000992654Background: The Gram stain can be used to direct initial empiric antimicrobial therapy when complete culture is not available. This rapid test could prevent the initiation of inappropriate therapy and adverse outcomes. However, several studies have attempted to determine the value of the Gram stain in the diagnosis and therapy of bacterial infection in different populations of patients with ventilator-associated pneumonia (VAP) with conflicting results. The objective of this study is to evaluate the accuracy of the Gram stain in predicting the existence of Staphylococcus aureus infections from cultures of patients suspected of having VAP. Methods: This prospective single-center open cohort study enrolled 399 patients from December 2005 to December 2010. Patients suspected of having VAP by ATS IDSA criteria were included. Respiratory secretion samples were collected by tracheal aspirate (TA) for standard bacterioscopic analysis by Gram stain and culture. Results: Respiratory secretion samples collected by tracheal aspirates of 392 patients were analyzed by Gram stain and culture. When Gram-positive cocci were arranged in clusters, the sensitivity was 68.4%, specificity 97.8%, positive predictive value 88.1% and negative predictive value 92.8% for predicting the presence of Staphylococcus aureus in culture (p < 0.001). Conclusions: A tracheal aspirate Gram stain can be used to rule out the presence of Staphylococcus aureus in patients with a clinical diagnosis of VAP with a 92.8% Negative Predictive Value. Therefore, 7.2% of patients with Staphylococcus aureus would not be protected by an empiric treatment that limits antimicrobial coverage to Staphylococcus aureus only when Gram positive cocci in clusters are identified.application/pdfengBMC anesthesiology. London. Vol. 15 (Jan. 2015), p. 19, [5] p.Pneumonia associada à ventilação mecânicaStaphylococcus aureusDoencas da traqueiaStaphylococcus aureusGram stainTracheal aspirateVentilator-associated pneumoniaAccuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumoniaEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT000992654.pdf.txt000992654.pdf.txtExtracted Texttext/plain21565http://www.lume.ufrgs.br/bitstream/10183/196820/2/000992654.pdf.txt264d982706c0353390314261a6b04565MD52ORIGINAL000992654.pdfTexto completo (inglês)application/pdf495437http://www.lume.ufrgs.br/bitstream/10183/196820/1/000992654.pdf101834320b6f8d28da6ea9de6f8db4fcMD5110183/1968202019-07-13 02:35:44.673163oai:www.lume.ufrgs.br:10183/196820Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2019-07-13T05:35:44Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia |
title |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia |
spellingShingle |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia Seligman, Renato Pneumonia associada à ventilação mecânica Staphylococcus aureus Doencas da traqueia Staphylococcus aureus Gram stain Tracheal aspirate Ventilator-associated pneumonia |
title_short |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia |
title_full |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia |
title_fullStr |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia |
title_full_unstemmed |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia |
title_sort |
Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia |
author |
Seligman, Renato |
author_facet |
Seligman, Renato Seligman, Beatriz Graeff Santos Konkewicz, Loriane Rita Santos, Rodrigo Pires dos |
author_role |
author |
author2 |
Seligman, Beatriz Graeff Santos Konkewicz, Loriane Rita Santos, Rodrigo Pires dos |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Seligman, Renato Seligman, Beatriz Graeff Santos Konkewicz, Loriane Rita Santos, Rodrigo Pires dos |
dc.subject.por.fl_str_mv |
Pneumonia associada à ventilação mecânica Staphylococcus aureus Doencas da traqueia |
topic |
Pneumonia associada à ventilação mecânica Staphylococcus aureus Doencas da traqueia Staphylococcus aureus Gram stain Tracheal aspirate Ventilator-associated pneumonia |
dc.subject.eng.fl_str_mv |
Staphylococcus aureus Gram stain Tracheal aspirate Ventilator-associated pneumonia |
description |
Background: The Gram stain can be used to direct initial empiric antimicrobial therapy when complete culture is not available. This rapid test could prevent the initiation of inappropriate therapy and adverse outcomes. However, several studies have attempted to determine the value of the Gram stain in the diagnosis and therapy of bacterial infection in different populations of patients with ventilator-associated pneumonia (VAP) with conflicting results. The objective of this study is to evaluate the accuracy of the Gram stain in predicting the existence of Staphylococcus aureus infections from cultures of patients suspected of having VAP. Methods: This prospective single-center open cohort study enrolled 399 patients from December 2005 to December 2010. Patients suspected of having VAP by ATS IDSA criteria were included. Respiratory secretion samples were collected by tracheal aspirate (TA) for standard bacterioscopic analysis by Gram stain and culture. Results: Respiratory secretion samples collected by tracheal aspirates of 392 patients were analyzed by Gram stain and culture. When Gram-positive cocci were arranged in clusters, the sensitivity was 68.4%, specificity 97.8%, positive predictive value 88.1% and negative predictive value 92.8% for predicting the presence of Staphylococcus aureus in culture (p < 0.001). Conclusions: A tracheal aspirate Gram stain can be used to rule out the presence of Staphylococcus aureus in patients with a clinical diagnosis of VAP with a 92.8% Negative Predictive Value. Therefore, 7.2% of patients with Staphylococcus aureus would not be protected by an empiric treatment that limits antimicrobial coverage to Staphylococcus aureus only when Gram positive cocci in clusters are identified. |
publishDate |
2015 |
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BMC anesthesiology. London. Vol. 15 (Jan. 2015), p. 19, [5] p. |
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