ArticleCritical care (London, England)2019
Invasive and non-invasive diagnostic approaches for microbiological diagnosis of hospital-acquired pneumonia.
Article in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- No difference in microbial diversity between bronchoalveolar lavage and tracheal sampling: a systematic review and meta-analysis.BMJ open respiratory research · 2025Pooled it
- Emerging strategies for the noninvasive diagnosis of nosocomial pneumonia.Expert review of anti-infective therapy · 2019Pooled it
- Severe community-acquired pneumonia: current concepts and controversies.Intensive care medicine · 2026Review
- Clinical usefulness of repeated sputum culture for the identification of pneumonia pathogens: A retrospective study.PloS one · 2026Article
- Management of mould pneumonia in resource-limited settings in Asia: A Delphi-based consensus statement by the Asia Fungal Working Group.Medical mycology · 2025Article
- Transforming Microbiological Diagnostics in Nosocomial Lower Respiratory Tract Infections: Innovations Shaping the Future.Diagnostics (Basel, Switzerland) · 2025Review
- Diagnostic Approach to Pneumonia in Immunocompromised Hosts.Journal of clinical medicine · 2025Review
- Distribution characteristics of aerosol microorganisms in bronchoscopy room and the risk assessment of nosocomial infection.Frontiers in public health · 2025Article
- The frequency and clinical features of posttransplant pneumonia in solid-organ transplantation recipients: A transplant center experience.Tuberkuloz ve toraks · 2024Article
- Neutrophil percentages in bronchoalveolar lavage fluid: Implications for diagnosing bacterial pneumonia in patients with immunocompromise and neutropenia.medRxiv : the preprint server for health sciences · 2024Article
- Antimicrobial De-Escalation in Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Prevalence of bacteria, fungi, and virus coinfections with SARS-CoV-2 Omicron variant among patients with severe COVID-19 in Guangzhou, China, winter 2022.Biosafety and health · 2024Article
- Ten Issues to Update in Nosocomial or Hospital-Acquired Pneumonia: An Expert Review.Journal of clinical medicine · 2023Review
- Comparison of endotracheal aspirate and bronchoalveolar lavage fluid metagenomic next-generation sequencing in severe pneumonia: a nested, matched case-control study.BMC infectious diseases · 2023Article
- Incidence and Outcomes of Non-Ventilator-Associated Hospital-Acquired Pneumonia in 284 US Hospitals Using Electronic Surveillance Criteria.JAMA network open · 2023Article
- Review
- Bronchoscopy on Intubated Patients with COVID-19 Is Associated with Low Infectious Risk to Operators.Annals of the American Thoracic Society · 2021Article
- Application of sputum suction by fiberoptic bronchoscope in patients with severe pneumonia and its effect on inflammatory factors.American journal of translational research · 2021Article
- Is ventilated hospital-acquired pneumonia a worse entity than ventilator-associated pneumonia?European respiratory review : an official journal of the European Respiratory Society · 2020Review
- Procalcitonin and C-reactive protein perform better than the neutrophil/lymphocyte count ratio in evaluating hospital acquired pneumonia.BMC pulmonary medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundData on the methods used for microbiological diagnosis of hospital-acquired pneumonia (HAP) are mainly extrapolated from ventilator-associated pneumonia. HAP poses additional challenges for respiratory sampling, and the utility of sputum or distal sampling in HAP has not been comprehensively evaluated, particularly in HAP admitted to the ICU.
methodsWe analyzed 200 patients with HAP from six ICUs in a teaching hospital in Barcelona, Spain. The respiratory sampling methods used were divided into non-invasive [sputum and endotracheal aspirate (EAT)] and invasive [fiberoptic-bronchoscopy aspirate (FBAS), and bronchoalveolar lavage (BAL)].
resultsA median of three diagnostic methods were applied [range 2-4]. At least one respiratory sampling method was applied in 93% of patients, and two or more were applied in 40%. Microbiological diagnosis was achieved in 99 (50%) patients, 69 (70%) by only one method (42% FBAS, 23% EAT, 15% sputum, 9% BAL, 7% blood culture, and 4% urinary antigen). Seventy-eight (39%) patients underwent a fiberoptic-bronchoscopy when not receiving mechanical ventilation. Higher rates of microbiological diagnosis were observed in the invasive group (56 vs. 39%, p = 0.018). Patients with microbiological diagnosis more frequently presented changes in their empirical antibiotic scheme, mainly de-escalation.
conclusionsA comprehensive approach might be undertaken for microbiological diagnosis in critically ill nonventilated HAP. Sputum sampling determined one third of microbiological diagnosis in HAP patients who were not subsequently intubated. Invasive methods were associated with higher rates of microbiological diagnosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.