Uso de cultivo cuantitativo de aspirado endotraqueal para el diagnóstico de neumonía asociada a ventilación mecánica en pediatría: Estudio prospectivo, analítico

Abstract

Introduction: Ventilator-associated pneumonia (VAP) is difficult to diagnose because of the absence of a gold standard. Aim: To evaluate the use of quantitative cultures of endotracheal aspirates for diagnosis of pediatric VAP and to obtain acceptable sensitivity and specificity cutoff points. Patients and Methods: Prospective, analytic study which included patients under 15 years, who were connected to mechanical ventilation at Hospital Luis Calvo Mackenna's intensive care units. They were classified as cases or controls according to NNIS criteria. Results: During a period of 21 months we recruited a total of 43 patients with a mean age of 16 months. We obtained endotracheal aspirated samples to perform quantitative cultures. Most frequently isolated pathogens were Staphylococcus aureus (34,5%) and non-fermentative Gram-negative bacilli (24,1%). We obtained a sensitivity of 88%, specificity of 70%, PPV of 82%, and NPV of 79% for samples greater than 10 6 CFU. Conclusions: Quantitative culture of endotracheal aspirates is a reliable method for diagnosing pediatric VAP when the value is greater than 10 6 CFU.