Diagnostic yield of endotracheal aspirate and bronchoalveolar lavage in ventilator-associated pneumonia: A single-centre study.

Ventilator-associated pneumonia (VAP) remains a significant cause of morbidity and mortality in critically ill patients. This study aimed to compare the diagnostic accuracy of endotracheal aspirate (ETA) with bronchoalveolar lavage (BAL) culture, considered the reference standard, in identifying the causative pathogens of VAP. This study was conducted as a cross-sectional study at Haji Adam Malik General Hospital, Medan, Indonesia. A total of 95 samples from mechanically ventilated patients were analysed using both ETA and BAL in similar institutions. The results demonstrated that 49 samples were positive by both ETA and BAL, while 11 were BAL-positive but ETA-negative, and 31 were ETApositive but BAL-negative. The sensitivity of ETA culture was 81.67%, whereas specificity was 11.43%. The positive predictive value (PPV) was 61.25%, and the negative predictive value (NPV) was 26.67%, yielding an overall diagnostic accuracy of 55.79%. These findings highlight the moderate reliability of ETA in detecting VAP pathogens, with limitations in ruling out infection due to its low NPV. To conclude, the relatively high sensitivity and ease of use suggest that ETA remains a useful initial diagnostic tool, particularly in resource-limited settings, though confirmation with more definitive methods, such as BAL, is recommended to guide appropriate antimicrobial therapy.