Processing of Endotracheal tips;
Dr.T.V.Rao MD
The Microbiology laboratories receive the ET tips for culture and
Antibioti...
Please observe the culture plates from an ET tube form a patient with Head injury on
pulmonary ventilation, and put on sev...
Upcoming SlideShare
Loading in …5
×

Processing of endotracheal tips

1,355 views

Published on

Processing of endotracheal tips

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,355
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
8
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Processing of endotracheal tips

  1. 1. Processing of Endotracheal tips; Dr.T.V.Rao MD The Microbiology laboratories receive the ET tips for culture and Antibiotic sensitivity. However Sputum and tracheal aspirates from intubated patients are regularly cultured in an attempt to diagnose pneumonia which is divided into four broad categories Community acquired pneumonia (CAP) Nosocomial or Hospital acquired pneumonia (HAP) and the important subset ventilator-associated pneumonia (VAP) Aspiration pneumonia Pneumonia in immunocompromised patients (e.g. HIV, transplant patients) The controversy continues whether we process endotracheal tips in our laboratories, the question remains to do or not? - Expectorated sputum is always contaminated to some degree with oropharengeal organisms. Because culture of mouth contents (saliva) is not useful in the diagnosis of lung infections, a microscopic screening process is used to guide culture and interpretation. So many reject the ET suction tubes and do not screen any endotracheal tube aspirates or suctioned samples. What we can do next if we do not process the ET tubes Screening Procedure Select the most purulent portion of the specimen for Gram staining and culture. Scan the smear under low power (10X objective) and examine for epithelial cells and WBCs. Rejection Criteria Greater than 10 epithelial cells / low power field – Discard culture plates without examining. Less than 10 epithelial cells / low power field – Examine and report, with quantitation, routine Gram stain results. Continue incubation of culture plate If the number of WBCs is 10 times the number of epithelial cells and there is 3+ or 4+ of a single morphotype of bacteria, accept the specimen and interpret the culture. (Infection net) Do realise Tracheo-bronchial aspirates- high sensitivity, however its weakness- as it does not differentiate between pathogen and colonizer However the events of infection in neonates are different, Data demonstrate that bacterial colonization of an indwelling object in the neonatal airway increases with the duration of intubation. Furthermore, 4 days seems to represent a critical period in the formation of such colonization (possibly in the form of a biofilm)
  2. 2. Please observe the culture plates from an ET tube form a patient with Head injury on pulmonary ventilation, and put on several new generations of Antibiotics, A careless reporting from this culture plates will be harmful to the present patient, if not interpreted judiciously as it is difficult to diagnose which is a real pathogen. Have wisdom before taking decisions to change the course of Antibiotic regimes after Culturing and doing Antibiograms Email doctortvrao@gmail.com

×