Table 5

Studies comparing quantitative cultures to clinical diagnosis

First author
Sample
Dx tests
Gold standard
Results

Camargo, 2004, ** [59]
Mixed ICU, 106 pts
TA (105 and 106) & TA (qualit)
Clinical (ad hoc)
• TA (106): sens = 26%, spec = 78%, PPV = 20%, NPV = 83%
• TA (105): sens = 65%, spec = 48%, PPV = 21%, NPV = 87%
• TA (qualit): sens = 81%, spec = 23%, PPV = 18%, NPV = 86%
Mentec, 2004, ** [60]
Mixed ICU, 63 pts
TA (105), bPTC (103), PTC (103), BAL (104)
Clinical + Rx (ad hoc)
• For quantitative cultures: TA: sens = 82%, spec = 67%, ROC = 0,78; bPTC: sens = 62%, spec = 94%, ROC = 0,83; PTC: sens = 71%, spec = 94%, ROC = 0,85; BAL: sens = 94%, spec = 100%, ROC = 0.98
• For Gram stain: TA: sens = 94%, spec = 50%; bPTC: sens = 56%, spec = 94%; PTC sens = 65%, spec = 83%; BAL sens = 100%, spec = 94%
Woske, 2001, ** [61]
Surgical ICU, 103 pts, consecutive
BAL (104) & PSB (103) & TA (105 and 106)
CPIS ≥6
• BAL: sens = 90%.
• PSB: sens = 83%.
• TA (105): sens = 90%.
• TA (106): sens = 50%.
Meduri, 1992, ** [84]
Mixed ICU, 25 pts
pBAL (104) & PSB
Clinical
• pBAL: Spec = 100%, NPV = 100%
Salata, 1987, ** [85]
Mixed ICU, 51 pts
TA
Clinical
• TA: higher Gram stain grading for neutrophils: p < 0.05
• TA: higher bacterial colony count: p < 0.05
Castro, 1991, ** [86]
Mixed ICU, 103 pts
PSB (103)
Clinical
• PSB: sens = 84%, spec = 67%

ICU = intensive care unit; TA = tracheal aspiration; qualit. = qualitative; BAL = bronchoalveolar lavage; sens = sensitivity; spec = specificity; bPTC = blinded protected telescoping catheter; PTC = protected (plugged) telescoping catheter; PPV = positive predictive value; NPV = negative predictive value; PSB = protected specimen brush; CPIS = clinical pulmonary infection score; pBAL = protected bronchoalveolar lavage; **consecutive

Rea-Neto et al. Critical Care 2008 12:R56   doi:10.1186/cc6877