Infection control and hospital epidemiology · 2020
Lack of utility of tracheal aspirates in the management of suspected pneumonia in intubated neonates.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Langston Seth J, Pithia Neema, Sim Myung Shin, Garg Meena, de St Maurice Annabelle, Chu Alison
Аннотация
OBJECTIVES: To evaluate the utility of tracheal aspirates in suspected pneumonia in intubated neonates and to measure the burden of antibiotic use associated with a positive tracheal aspirate culture.
DESIGN: Retrospective cohort study between January 2016 and December 2017.
SETTING: A level IV neonatal intensive care unit (NICU).
PATIENTS: Intubated patients with a tracheal aspirate culture.
METHODS: Data on temporally associated clinical measures of illness, laboratory and radiographic testing, and clinical demographic information were analyzed.
RESULTS: Positive tracheal aspirate cultures were associated with lower birth weight and a normal immature to total neutrophil ratio (I/T ratio). Positive tracheal aspirates were not significantly associated with clinical, laboratory, or radiographic markers used in clinical practice to screen for infection. Despite the lack of positive clinical associations, a positive tracheal aspirate culture was associated with increased risk of prolonged antibiotic exposure.
CONCLUSION: These findings suggest that positive tracheal aspirates do not always represent clinical infection and may result in unnecessary antibiotic exposure.
DESIGN: Retrospective cohort study between January 2016 and December 2017.
SETTING: A level IV neonatal intensive care unit (NICU).
PATIENTS: Intubated patients with a tracheal aspirate culture.
METHODS: Data on temporally associated clinical measures of illness, laboratory and radiographic testing, and clinical demographic information were analyzed.
RESULTS: Positive tracheal aspirate cultures were associated with lower birth weight and a normal immature to total neutrophil ratio (I/T ratio). Positive tracheal aspirates were not significantly associated with clinical, laboratory, or radiographic markers used in clinical practice to screen for infection. Despite the lack of positive clinical associations, a positive tracheal aspirate culture was associated with increased risk of prolonged antibiotic exposure.
CONCLUSION: These findings suggest that positive tracheal aspirates do not always represent clinical infection and may result in unnecessary antibiotic exposure.