Table 4.
Prior antibiotic therapy | Overall | Percentage performed | Chi-square P value | ||
No | Yes | ||||
Pathogens (%) | 0.002 | ||||
None | 27.5 | 51.8 | 52.5 | ||
Monomicrobial | 33.3 | 29.0 | 29.9 | ||
Polymicrobial | 39.2 | 19.2 | 23.8 | ||
Yield of microbial investigations (%) | |||||
Tracheal aspirate | 87.5 | 79.5 | 81.4 | 81.6 | |
Protected specimen brush | 96.3 | 67.9 | 80.0 | 32.8 | |
Bronchoalveolar lavage | 100 | 71.4 | 77.5 | 4.1 | |
Pathogens identified (all patients) | |||||
Monomicrobial | 17 | 56 | 73 | 0.02 | |
Pseudomonas aeruginosa | 1 | 13 | 14 | ||
Other Pseudomonas | 0 | 2 | 2 | ||
Acinetobacter baumannii | 0 | 11 | 11 | ||
Other Acinetobacter | 0 | 1 | 1 | ||
Enterobacteriaceae | 3 | 12 | 15 | ||
Staphylococcus aureus | 4 | 9 | 13 | ||
Haemophylus influenzae | 6 | 5 | 11 | ||
Streptococcus pneumoniae | 2 | 2 | 4 | ||
Streptococcus viridans group | 0 | 0 | 0 | ||
Other | 1 | 1 | 2 | ||
Polymicrobial | 20 | 38 | 58 | <0.001 | |
Mixed, including NFGNB and methicillin-resistant S. aureus | 4 | 23 | 27 | ||
H. influenzae plus Streptococcus spp. | 9 | 2 | 11 | ||
Other | 7 | 13 | 20 | ||
Pathogens identified (Group Va) | |||||
Monomicrobial | 1 | 7 | 8 | ||
P. aeruginosa | 1 | 2 | 3 | ||
Other NFGNB | 0 | 2 | 2 | ||
Enterobacteriaceae | 0 | 1 | 1 | ||
Methicillin-resistant S. aureus | 0 | 1 | 1 | ||
Other | 0 | 1 | 1 | ||
Polymicrobial | 4 | 11 | 15 | ||
Mixed, including NFGNB and methicillin-resistant S. aureus | 1 | 8 | 9 | ||
Other | 3 | 3 | 6 |
NFGNB, nonfermenting Gram-negative bacilli. Overall, there were 33 Pseudomonas isolates, including 30 Pseudomonas aeruginosa, two Pseudomonas putida, and one Pseudomonas spp., and 22 Acinetobacter isolates, including 20 A. baumannii, one Acinetobacter haemolyticus, and one Acinetobacter calcoaceticus. aGroup V, patients who initially received inadequate antibiotic therapy, which was later modified on the basis of cultures.