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Lack of utility of tracheal aspirates in the management of suspected pneumonia in intubated neonates

Published online by Cambridge University Press:  25 March 2020

Seth J. Langston ,
Neema Pithia ,
Myung Shin Sim ,
Meena Garg ,
Annabelle de St Maurice  and
Alison Chu Open the ORCID record for Alison Chu [Opens in a new window]
Seth J. Langston
Affiliation:
Division of Neonatology and Developmental Biology, Department of Pediatrics, David Geffen School of Medicine University of California Los Angeles, Los Angeles, California
Neema Pithia
Affiliation:
Division of General Pediatrics, Department of Pediatrics, David Geffen School of Medicine University of California Los Angeles, Los Angeles, California
Myung Shin Sim
Affiliation:
Statistics Core, Department of Medicine, David Geffen School of Medicine University of California Los Angeles, Los Angeles, California
Meena Garg
Affiliation:
Division of Neonatology and Developmental Biology, Department of Pediatrics, David Geffen School of Medicine University of California Los Angeles, Los Angeles, California
Annabelle de St Maurice
Affiliation:
Division of Pediatric Infectious Diseases, Department of Pediatrics, David Geffen School of Medicine University of California Los Angeles, Los Angeles, California
Alison Chu*
Affiliation:
Division of Neonatology and Developmental Biology, Department of Pediatrics, David Geffen School of Medicine University of California Los Angeles, Los Angeles, California
*
Author for correspondence: Alison Chu, E-mail: [email protected]
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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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 6 , June 2020 , pp. 660 - 665
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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