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E-ISSN: 2717-9206
The retrospective analysis of the value of endotracheal aspirate cultures for the diagnosis of ventilator-associated pneumonia in pediatric intensive care unit
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Original Research
VOLUME: 2 ISSUE: 1
P: 13-18
April 2015

The retrospective analysis of the value of endotracheal aspirate cultures for the diagnosis of ventilator-associated pneumonia in pediatric intensive care unit

J Pediatr Emerg Intensive Care Med 2015;2(1):13-18
DOI: 10.5505/cayb.2015.44127
Kadir Şerafettin Tekgündüz
Mustafa Bulgan
Merve Türkay
1. Atatürk Üniversitesi Tıp Fakültesi Çocuk Sağlığı Ve Hastalıkları Ad, Erzurum
No information available.
No information available
Received Date: 07.01.2015
Accepted Date: 18.02.2015
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ABSTRACT

OBJECTIVE:

Ventilator-associated pneumonia (VAP) refers to pneumonia that develops in patients on invasive mechanical ventilation. Making an accurate diagnosis of VAP has been a challenge to clinicians. The Clinical Pulmonary Infection Score (CPIS) was developed to serve as a surrogate tool to facilitate the diagnosis of ventilator-associated pneumonia. The aim of this study was to assess the value of the combination of endotracheal aspirate (ETA) culture and CPIS.

METHODS:

Seventeen episodes of culture-positive endotracheal aspirates were analysed retrospectively in 9 mechanically ventilated children. VAP was diagnosed according to the Center for Disease Control (CDC) criteria. CPIS scores were calculated by adding ETA culture results.

RESULTS:

There were a total of 33 patients in the study period. The median age at the admission was There were a total of 33 patients in the study period. The median age at the admission was 3,4±2.1 years. 22 (67%) of the patients were male. Fever was the first symptom in 84% and meningococcemic rashes were peresent at the admission in 97% of the patients. Lumbar puncture was performed in 45% of the patients and 7 (21%) of them had meningitis with meningococcemia. N. meningitidis was cultured from 7 blood and 2 cerebrospinal fluid samples. An average of 60 mL/kg fluid bolus was given to 93% of the patients within the first hour of hospital admission. Dopamine, dobutamine, and epinephrine were given to patients who required inotropic and vasopressor infusions (54.5%, 27.2%, 12.1% of the patients, respectively). Fifty-eight percent of the patients received steroid therapy and 12% of them received heparin infusion for disseminated intravascular coagulation and purpura fulminans. The mean length of PICU stay was 6 days (1 to 29 days) and the overall mortality rate was 21% (7 patients).

CONCLUSION:

As a single tool, ETA cultures do not appear to distinguish between infection and colonization. Our results suggest that the ETA-CPIS had a clinically acceptable performance, and it can be a helpful screening tool for VAP diagnosis. However, prospective large studies are required to determine the clinical value of ETA-CPIS.

Keywords:
Intensive care, pneumonia, ventilators, mechanical