Ventilator-associated pneumonia related to surveillance cultures and bronchoalveolar lavage

In approximately three-quarters of all Dutch Intensive Care Departments, cultures are taken for preventive purposes in order to assess which potentially pathogenic bacteria are carried by the patient. Studies on these ‘surveillance cultures’ are usually quasi-experimental and difficult to compare with each other. An analysis of 4,184 potentially pathogenic microorganisms identified from (surveillance) cultures showed that the classification of ventilator-associated pneumonia on the basis of time of origin serves no purpose. This current practice can lead to insufficient treatment or even death. An analysis of 311 patients suspected of ventilator-associated pneumonia demonstrates that two frequently used diagnostic techniques are less interchangeable than currently thought. Further research must show what the exact implication of these differences is for practice. Furthermore, Scholte considers throat microbiota deemed harmless as yet and the bacterium Stenotrophomonas maltophilia as potential causes of ventilator-associated pneumonia.