Microbiological analysis of endotracheal aspirate and endotracheal tube cultures in mechanically ventilated patients

BMC Pulm Med. 2019 Aug 27;19(1):162. doi: 10.1186/s12890-019-0926-3.

Abstract

Background: To compare the microbiological culture within endotracheal aspirate specimens (ETAs) and endotracheal tube specimens (ETTs) in patients undergoing mechanical ventilation (MV) by statistical tools.

Method: ETAs and ETTs from a total number of 81 patients, who were undergoing MV at the intensive care unit (ICU) of Jiading Central Hospital Affiliated Shanghai University of Medicine & Health Sciences from September 1st, 2017 to August 31st, 2018, were collected for microbiological culture analysis. Correlation of ETAs and ETTs cultures were obtained by Spear-men correlation analysis, while the consistency of the two specimens was determined by Kappa analysis and principal component analysis (PCA).

Results: Microbiological culture from both ETAs and ETTs showed that Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens, with Spear-man correlation coefficients of 0.676, 0.951, 0.730 and 0.687 respectively (all P < 0.01), and the overall Spear-man correlation coefficient is 0.757 (P < 0.01). This result shows that two samples were positively correlated. Kappa analysis also revealed high consistency of the microbial culture results from the ETAs and the ETTs (overall κ = 0.751, P < 0.01). The κ values for the four bacteria detected were 0.670, 0.949, 0.723, and 0.687, respectively (all P < 0.001). PCA also revealed high similarity.

Conclusion: Combining microbiological culture and statistical analysis of samples collected from 81 patients who were undergoing MV in ICU, we showed that microbe found in the ETAs had high similarity with that found in the ETTs which collected at the end of the catheters. In clinical practice, ETAs analysis is easily accessible meanwhile provides a valuable information for MV patients.

Keywords: Clinical value; Consistency analysis; Endotracheal tube; Eracheal aspirate; Mechanical ventilation; Microorganism.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biofilms*
  • China
  • Colony Count, Microbial
  • Equipment Contamination*
  • Female
  • Gram-Negative Bacteria
  • Gram-Positive Bacteria
  • Humans
  • Intensive Care Units
  • Intubation, Intratracheal / adverse effects*
  • Male
  • Middle Aged
  • Respiration, Artificial / adverse effects*
  • Respiratory Tract Infections / etiology*
  • Respiratory Tract Infections / mortality
  • Trachea / microbiology*