الفهرس | Only 14 pages are availabe for public view |
Abstract Ventilator-associated pneumonia (VAP) is the main cause of newly developed radiological infiltrates in an intensive-care setting. The aim of the current study was to evaluate the role of broncho-alveolar lavage fluid cultures sampled using the mini-BAL maneuver in the diagnosis of newly developed pulmonary infiltrates in mechanically ventilated patients. The present study included 30 mechanically ventilated patients of different ages and gender. Mini-BAL technique was used for collection of bronchial aspirate which was then examined by cultures and sensitivity and colony count. Some patients had more than one isolated organism, Microbial tests were positive for 27 patients some of whom had more than one organism. Some patients were sensitive to more than one antibiotic. According to cytological examination revealed only one patient positive for malignancy and 29 negative for malignancy. Finally, 20 patients weaned from mechanical ventilation and 10 patients died. Patients had more than one organism as follow 14 (46.7%) patients had unimicrobial, 5 (16.7%) patients had bimicrobial and 8 (26.7%) patients had polymicrobial. Microbial yield of mini BAL N (%) In the present study, Klebsiella spp. are most commonly isolated bacterial 44.4% while candida spp. 23.3% are the most commonly isolated fungal organism in mechanically ventilated patients. Patients’ fate whether weaned or died was 58.45±5.75 or 67.20±6.36 in correlation to the age of patients with statistical significance difference with t=3.80, at p=0.001. While there is no statistically significant correlation between the fate and co-morbidities, PaO2/FiO2 ratio, CPIS score and microbiology results. We also found that there is statistically significance difference between fate of the patients and serum urea with t=2.05, at p=0.049 while other laboratory results showed no significance. There was a statistically significant association (correlation) between WBCs and ≥6 CPIS (p=0.024*). Therefore, those who had higher WBCs were 1.521 times more likely to have disease. There was a statistically significant association (correlation) between GRAM.CHROM and ≥6 CPIS (p<0.001). Therefore, those who had higher GRAM.CHROM (Klebsiella and Pseudomonus) were 9.0 times more likely to have disease (OR = 9.0). |