Abstract
The value of direct examination of Giemsa and Gram stains of cytospin preparations of protected specimen brush samples was compared to that of quantitative culture. Sixty-one samples from patients suspected to have nosocomial pneumonia were analysed. Twenty-five samples were positive by quantitative culture, 21 of which contained microorganisms seen by direct examination. The presence of leucocytes was not specific for a positive culture, but in their absence, a positive culture was unlikely. The presence of intracellular organisms always correlated with a positive culture, but was not very sensitive.
Keywords: Internal Medicine, Pneumonia, Positive Culture, Nosocomial Pneumonia, Direct Examination
References
- 1.Chastre J, Viau F, Brun P, Pierre J, Dauge MC, Bouchama A, Akesbi A, Gibert C. Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patients. American Review of Respiratory Disease. 1984;130:924–929. doi: 10.1164/arrd.1984.130.5.924. [DOI] [PubMed] [Google Scholar]
- 2.Chastre J, Fagon JY, Soler P, Bornet M, Domart Y, Trouillet JL, Gibert C, Hance AJ. Diagnosis of nosocomial pneumonia in intubated patients undergoing ventilation: comparison of usefulness of bronchoalveolar lavage and protected specimen brush. American Journal of Medicine. 1988;85:499–506. doi: 10.1016/s0002-9343(88)80085-8. [DOI] [PubMed] [Google Scholar]
- 3.Chastre J, Fagon JY, Soler P, Domart Y, Pierre J, Dombret MC, Gibert C, Hance AJ. Quantification of BAL cells containing intracellular bacteria rapidly identifies ventilated patients with nosocomial pneumonia. Chest. 1989;95(Supplement 2):190–192. [Google Scholar]
- 4.Chastre J, Fagon JY, Bornet-Lecso M, Calvat S, Dombret MC, Khani RA, Basset F, Gibert C. Evaluation of bronchoscopic techniques for the diagnosis of nosocomial pneumonia. American Journal of Respiratory and Critical Care Medicine. 1995;152:231–240. doi: 10.1164/ajrccm.152.1.7599829. [DOI] [PubMed] [Google Scholar]
- 5.Marquette CH, Ramon P, Courcol R, Wallaert B, Tonnel AB, Voisin C. Bronchoscopic protected catheter brush for the diagnosis of pulmonary infections. Chest. 1988;93:746–750. doi: 10.1378/chest.93.4.746. [DOI] [PubMed] [Google Scholar]
- 6.Higuchi JG, Coolson JJ, Johanson WG. Bacteriologic diagnosis of nosocomial pneumonia in primates. American Review of Respiratory Disease. 1982;125:53–57. doi: 10.1164/arrd.1982.125.1.53. [DOI] [PubMed] [Google Scholar]
- 7.Meduri GU, Beals DH, Maijub AG, Baselski V. Protected bronchoalveolar lavage: a new bronchoscopic technique to retrieve uncontaminated distal airway secretions. American Review of Respiratory Disease. 1991;143:855–864. doi: 10.1164/ajrccm/143.4_Pt_1.855. [DOI] [PubMed] [Google Scholar]
- 8.Pollock HM, Hawkins EL, Bonner JR, Sparkman T, Bass JB. Diagnosis of bacterial pulmonary infections with quantitative protected catheter cultures obtained during bronchoscopy. Journal of Clinical Microbiology. 1983;17:255–259. doi: 10.1128/jcm.17.2.255-259.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Teaque RB, Wallace RJ, Awe RJ. The use of quantitative sterile brush culture and Gram stain analysis in the diagnosis of lower respiratory tract infection. Chest. 1981;79:157–161. doi: 10.1378/chest.79.2.157. [DOI] [PubMed] [Google Scholar]
- 10.Chapin-Robertson K, Dahlberg SE, Edberg SC. Clinical and laboratory analyses of cytospin-prepared Gram stains for recovery and diagnosis of bacteria from sterile body fluids. Journal of Clinical Microbiology. 1992;30:377–380. doi: 10.1128/jcm.30.2.377-380.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Marquette CH, Wallet F, Nevière R, Copin MC, Saulnier F, Drault JN, Mehdaoui H, Mathieu D, Ramon P. Diagnostic value of direct examination of the protected specimen brush in ventilator-associated pneumonia. European Respiratory Journal. 1994;7:105–113. doi: 10.1183/09031936.94.07010105. [DOI] [PubMed] [Google Scholar]
- 12.Meduri GU, Belenchia JM, Estes RJ, Wunderink RG, El Torky M, Leeper KV. Fibroproliferative phase of ARDS: clinical findings and effects of corticoids. Chest. 1991;100:943–952. doi: 10.1378/chest.100.4.943. [DOI] [PubMed] [Google Scholar]
- 13.Solé-Violan J, Rodrigez de Castro F, Rey A, Martin-Gonzalez J, Cabrero-Navarro P. Usefulness of microscopic examination of intracellular organisms in lavage fluid in ventilator-associated pneumonia. Chest. 1994;106:889–894. doi: 10.1378/chest.106.3.889. [DOI] [PubMed] [Google Scholar]
- 14.Marquette CH, Copin MC, Wallet F, Nevière R, Saulnier F, Mathieu D, Durocher A, Ramon P, Tonnel AB. Diagnostic tests for pneumonia in ventilated patients: prospective evaluation of diagnostic accuracy using histology as a diagnostic gold standard. American Journal of Respiratory and Critical Care Medicine. 1995;151:1878–1888. doi: 10.1164/ajrccm.151.6.7767535. [DOI] [PubMed] [Google Scholar]