Lack of utility of tracheal aspirates in the management of suspected pneumonia in intubated neonates. (June 2020)

• Record Type: Journal Article
• Authors: Langston, Seth J.; Pithia, Neema; Sim, Myung Shin; Garg, Meena; de St Maurice, Annabelle; Chu, Alison
• Is Part Of: Infection control and hospital epidemiology. Volume 41:Number 6(2020)
• Page Start: 660
• Page End: 665
• Publication Date: 2020-06
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2020.57
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract: 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.