Validation of an algorithm based on direct examination of specimens in suspected ventilator-associated pneumonia

Intensive Care Medicine
Anne VeinsteinF Blot

Abstract

The management of suspected ventilator-associated pneumonia (VAP) is traditionally based on either a clinical or a "bacteriological" approach. Direct examination of specimens may provide a valuable help to both approaches. The objective was to test an algorithm for the management of suspected pneumonia based on severity criteria and Gram stains of specimens, including early treatment of patients with a positive Gram stain of a protected telescoping catheter specimen and awaiting culture results in patients with either Gram stains of endotracheal aspirate and protected specimen both being negative, or only positive endotracheal aspirate (EA), except in the presence of the severity criteria. Observational study including 76 first episodes of suspected pneumonia in 4 units. We assessed the rates of correctly diagnosed episodes and of those treated empirically (i.e., ultimately confirmed pneumonia), or appropriately not receiving such therapy (non-confirmed pneumonia), based on protected specimen culture results. When adhered to, the algorithm allowed early appropriate management in 80% of patients, including 83% of those with confirmed pneumonia, and 74% of those without confirmed infection. The rate of appropriately managed episo...Continue Reading

References

Jun 1, 1992·Chest·W A KnausD P Wagner
Jul 1, 1995·American Journal of Respiratory and Critical Care Medicine·B JourdainJ Chastre
Dec 22, 1993·JAMA : the Journal of the American Medical Association·J R Le GallF Saulnier
Jul 1, 1997·American Journal of Respiratory and Critical Care Medicine·J RelloJ Valles
Dec 31, 1997·American Journal of Respiratory and Critical Care Medicine·M J BontenC A Gaillard
Feb 26, 1998·American Journal of Respiratory and Critical Care Medicine·J L TrouilletC Gibert
Nov 9, 2000·American Journal of Respiratory and Critical Care Medicine·F BlotG Nitenberg
Jan 12, 2001·The European Respiratory Journal·F BregeonJ P Auffray
Feb 22, 2001·Annals of Internal Medicine·M H Kollef, V J Fraser
Apr 6, 2002·American Journal of Respiratory and Critical Care Medicine·Jean Chastre, Jean-Yves Fagon
Feb 14, 2003·Intensive Care Medicine·R D HubmayrUNKNOWN Société de Réanimation de Langue Française
May 10, 2003·American Journal of Respiratory and Critical Care Medicine·Muriel FartoukhChristian Brun-Buisson
Feb 9, 2005·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN Infectious Diseases Society of America

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Citations

Apr 7, 2007·Current Opinion in Pulmonary Medicine·Graciela J Soto
Jun 9, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John C O'HoroNasia Safdar
Oct 3, 2009·Journal of Perinatology : Official Journal of the California Perinatal Association·Y KatayamaY K Lee
Oct 22, 2008·Expert Opinion on Pharmacotherapy·Diogo Diniz Gomes BuganoEliezer Silva
Jul 16, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andre C KalilJan L Brozek
Nov 21, 2008·Journal of Intensive Care Medicine·Margaret Bonnie RosboltBrenda G Fahy
Jan 24, 2014·Current Opinion in Infectious Diseases·Carlos M LunaAlejandro Raimondi

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