Diagnosis of ventilator-associated pneumonia: Comparison between ante-mortem and post-mortem cultures in trauma patients.
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Date
2014-07
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Abstract
Purpose: To evaluate the diagnostic utility of ante‑mortem tracheal aspirates for diagnosis of ventilator‑associated
pneumonia (VAP). Trauma victims represent an otherwise healthy population, who are on multiple invasive life‑support
devices, which predispose them to severe infections like VAP. The diagnosis of VAP is challenging, due to the difficulty
in obtaining a representative sample from lungs. We studied the diagnostic utility of tracheal aspirates by comparing its
results with the post‑mortem lung cultures. Materials and Methods: A total of 106 fatal trauma patients were included
in the study. Lung samples and cardiac blood were taken for culture at the time of autopsy. The results of ante‑mortem
and post‑mortem cultures were compared. Results: Septicemia was the cause of death in 51 (48%) of the fatal cases
and VAP was identified in 36 (34%) cases. A total of 96 (90.5%) cases had pathogens isolated from lung samples. In
62 (58%) cases, the same organism was isolated from ante‑mortem and post‑mortem respiratory samples. Conclusions:
Culture results of a properly collected tracheal aspirate should be taken into consideration along with Centre for Disease
Control and Prevention (CDC’s) diagnostic criteria to maximise the diagnosis of VAP.
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Keywords
Autopsy, Blood stream infections, intensive care unit, ventilator‑associated pneumonia, trauma
Citation
Lalwani S, Mathur P, Tak V, Janani S, S Kumar I, Bagla R, Misra M C. Diagnosis of ventilator-associated pneumonia: Comparison between ante-mortem and post-mortem cultures in trauma patients. Indian Journal of Medical Microbiology. 2014 Jul-Sept ; 32 (3): 294-300.