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THE VALUE OF GRAM–STAIN AND CELLULAR ANALYSIS OF THE BRONCHOALVEOLAR LAVAGE FLUIDS IN EARLY DIAGNOSIS OF VENTILATOR ASSOCIATED PNEUMONIAE IN CHILDREN
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Abstract
Objectives: Ventilator associated pneumoniae was common in the intensive care unit. Ealy diagnosis brought profound benefits but still in trouble. Fibre-bronchoscopy, an invasive intervention, showed numerous effectivenesses in diagnosis, treatments and prognosis in Pediatric intensive care units, including VAP diagnosis. The aims of this research to assess the benefits of Gram stains and cell clascificattions of bronchoalveolar lavage fluids in diagnosis of VAP. Subjects and methods: descriptive study was conducted in the Intensive care unit in the National Children Hospital to following up 93 participants suspected VAP by CDC criteria. Results: 93 patiens included in the study. 63.4% of the participants were males, and 62% of them were under 12 months old. VAP diagnosis was based on a positive quantitative culture of bronchoalveolar lavage fluid (cutoff > or = 104 CFU/mL). A final diagnosis of VAP was established in 44 patients and there was no infection in 49 cases. Regarding detection of bacteria using the Gram stain, we found a sensitivity of 100%, a specificity of 79,6%, a positive predictive value of 81,5% and a negative predictive value of 100%. The classification of bronchoalveolar lavage fluids (more than 25 neutrofil cells or more than 2% of inflammation cells) showed a high sensitivity of 93%, but low specificity. Conclusion: it was beneficial to use gram stains of bronchoalveolar lavage fluids in the diagnosis of VAP in Pediatric intensive care unit. Gram stains bronchoalveolar lavage fluids were negative could excluded VAP.
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Keywords
Ventilator associated pneuoniae, bronchoalveaolar lavage fluid, gram stains
References
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