Direct testing of bronchoalveolar lavages from ventilator-associated pneumonia patients

Diagn Microbiol Infect Dis. 2012 Jun;73(2):107-10. doi: 10.1016/j.diagmicrobio.2012.02.017. Epub 2012 Apr 5.


In line with a rapid de-escalation of empirical antimicrobial therapy, this study assessed the validity of an E-test-based direct specimen testing method on bronchoalveolar lavage (BAL) samples from ventilator-associated pneumonia (VAP) patients. E-test strips were directly applied onto Mueller-Hinton agar plates seeded with BAL samples and read after 24 h of incubation. In parallel, the BAL samples were analyzed by the routine diagnostic laboratory. The microbroth dilution approach was used as a control method. In a cohort of 20 patients, 135 microorganism-antibiotic combinations were studied. Total agreement between the 2 methods was achieved for 88.9% combinations, with 1.5% very major errors (isolates susceptible by E-test and reported resistant by the diagnostic laboratory) and 9.6% major errors (isolates resistant by E-test and reported susceptible by the diagnostic laboratory). These results indicate that applying E-test directly on BAL samples is a promising method for obtaining susceptibility data after 24 h in critical patients with VAP.

Trial registration: NCT01042353.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Bacteria / drug effects
  • Bacteria / isolation & purification
  • Bronchoalveolar Lavage Fluid / microbiology*
  • Cohort Studies
  • Coinfection / diagnosis
  • Coinfection / microbiology
  • Humans
  • Microbial Sensitivity Tests / methods*
  • Pneumonia, Bacterial / diagnosis
  • Pneumonia, Bacterial / microbiology
  • Pneumonia, Ventilator-Associated / diagnosis
  • Pneumonia, Ventilator-Associated / microbiology*
  • Reproducibility of Results


  • Anti-Bacterial Agents

Associated data