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01-05-2008 | Original

Influence of antibiotic therapy on the cytological diagnosis of ventilator-associated pneumonia

Authors: Catharina F. M. Linssen, Jan A. Jacobs, Jan S. A. G. Schouten, Walther N. K. A. van Mook, Graham Ramsay, Marjolein Drent

Published in: Intensive Care Medicine | Issue 5/2008

Abstract

Objective

To assess the influence of antibiotics on the value of various cytological parameters, and their combinations, in diagnosing ventilator-associated pneumonia (VAP).

Design

Prospective study.

Setting

The general intensive care unit (17 beds) of the University Hospital Maastricht.

Patients

Three hundred and thirty-five episodes of clinically suspected VAP (defined by the clinical and radiological criteria previously described by Bonten et al.) in 282 patients were studied.

Interventions

No additional interventions were conducted.

Measurements and results

Bronchoalveolar lavage fluid cytology included a total cell count per millilitre, differential cell count and the percentage of infected cells (cells containing phagocytised organisms). Antibiotic therapy from 72 h prior to lavage was recorded. Areas under the curve (AUCs) of receiver operating characteristic curves were calculated for various cytological parameters and their combinations, in patients with and without antibiotic therapy. In 126 episodes (37.6%) in 106 patients, VAP was confirmed. There was no difference in AUCs between patients with and without antibiotic therapy for any parameter studied. The most prominent AUCs were (for patient groups with and without antibiotics combined): total cell count, 0.65; percentage polymorphonuclear neutrophils, 0.71; and percentage infected cells, 0.90. The combination of percentage infected cells with any other cytological parameter did not increase the AUC.

Conclusion

Antibiotic therapy did not influence the predictive value of the percentage infected cells in BALF in diagnosing VAP.

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Title: Influence of antibiotic therapy on the cytological diagnosis of ventilator-associated pneumonia
Authors: Catharina F. M. Linssen
Jan A. Jacobs
Jan S. A. G. Schouten
Walther N. K. A. van Mook
Graham Ramsay
Marjolein Drent
Publication date: 01-05-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 5/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1015-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Influence of antibiotic therapy on the cytological diagnosis of ventilator-associated pneumonia

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

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