Reproducibility of protected specimen brush and bronchoalveolar lavage conserved at 4°C for 48 hours

被引:10
作者
Forceville, X
Fiacre, A
Faibis, F
Lahilaire, P
Demachy, MC
Combes, A
机构
[1] Ctr Hosp Meaux, Serv Reanimat Polyvalente, F-77104 Meaux, France
[2] Ctr Hosp Meaux, Hop St Faron, Microbiol Serv, F-77104 Meaux, France
关键词
pneumonia; protected specimen brush; bronchoalveolar lavage; microbiology; specimen handling;
D O I
10.1007/s00134-002-1329-z
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: Protected specimen brush (PSB) and bronchoalveolar lavage (BAL) are proposed in combination to optimize antimicrobial treatment. Nevertheless, they are only validated for immediate laboratory processing. This study was therefore conducted to determine whether 48h conservation at a mere 4degreesC enables good culture reproducibility for both PSB and BAL. Design and setting: Prospective study, evaluation of a conservation procedure for PSB and BAL, from February 1994 to February 1995, in the 12bed ICU of a general hospital (938 beds). Samples: Ninety-nine PSB and 86 BAL samples, obtained from 100 bronchoscopic procedures, were analyzed. Thresholds were 10(3) and 10(4) cfu/ml for PSB and BAL, respectively. Measurements and results: Qualitative comparison between the immediate and 48h procedures were, for PSB, specificity 100%, sensitivity 78%, positive predictive value 100%, negative predictive value 84% and overall accuracy 90%; and for BAL: 100%, 89%, 100%, 89% and 94%. Lowered. 102 and 103 cfu/ml thresholds at the 48h procedure for PSB and BAL reduce the false negatives from 10 to 3 and 5 to 1, respectively. Microorganism results were comparable for PSB and BAL (r=0.63 and 0.67), especially for the most resistant strains: Staphylococcus, Enterobacteriaceae and Pseudomonas. However, there was a decrease in the Neisseria and Haemophilus group (p<0.01). Conclusion: There is a good culture reproducibility for both PSB and BAL after 48h conservation at 4degreesC, especially with lowered thresholds; this technique is therefore appropriate for routine use.
引用
收藏
页码:857 / 863
页数:7
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