RT Journal Article
T1 Gradient diffusion antibiogram used directly on bronchial aspirates for a rapid diagnosis of ventilator-associated pneumonia
A1 Burillo Albizua, Almudena
A1 Egea, Viviana de
A1 Onori, Raffaella
A1 Martín-Rabadán, Pablo
A1 Cercenado Mansilla, Emilia
A1 Jiménez-Navarro, Laura
A1 Muñoz García, Patricia Carmen
A1 Bouza Santiago, Emilio
AB BackgroundIn patients with suspected ventilator-associated pneumonia, a rapid etiological diagnosis is crucial as incorrect or delayed treatment in the first few hours leads to a worse prognosis and a higher mortality rate. This study examines the efficacy of a rapid antibiogram on bronchial aspirates in patients with suspected ventilator-associated pneumonia (VAP).MethodsThe direct gradient diffusion susceptibility testing method (GDM) on respiratory samples was compared with a standard broth microdilution method (BMD) after quantitative cultures in patients with suspicion of VAP. Samples were preselected by Gram staining (for good quality microbiological samples with a predominant single bacterial morphotype). The antibiotics tested were ceftazidime, ceftobiprole, ceftolozane-tazobactam, meropenem, doripenem, and tedizolid.ResultsOver a 16-month study period, 445 bronchial aspirate samples were selected from 1376 samples received at our laboratory from 672 adult patients. By direct plating on Mueller-Hinton agar, we recovered 504 (95.5%) of the 528 microorganisms identified by the standard semiquantitative method. Antimicrobial susceptibility testing by GDM was compared with the BMD method in 472 strains (216Enterobacteriaceae, 138P. aeruginosaand 118 S. aureus.) and 1652 individual microorganism-antimicrobial agent combinations. There was total agreement between both methods in 98% of combinations. The Kappa index between both techniques was excellent (over 80%). There was only one potential major error forP. aeruginosasusceptibility to ceftazidime.ConclusionsThe six GDM strips directly placed on plated bronchial aspirates obtained from patients with a suspicion of VAP provided accurate and reliable susceptibility results within 24 h.
SN 2047-2994
YR 2019
FD 2019
LK https://hdl.handle.net/20.500.14352/116482
UL https://hdl.handle.net/20.500.14352/116482
LA eng
NO Burillo, A., de Egea, V., Onori, R. et al. Gradient diffusion antibiogram used directly on bronchial aspirates for a rapid diagnosis of ventilator-associated pneumonia. Antimicrob Resist Infect Control 8, 176 (2019). https://doi.org/10.1186/s13756-019-0640-1
DS Docta Complutense
RD 9 abr 2025