Identification (ID) and antimicrobial susceptibility testing (AST) of respiratory pathogens are critical to the management of patients with pneumonia to facilitate optimal antibiotic therapy selection. Few studies have examined the time to results (TTR) for this critical specimen, and such data can be valuable for benchmarking the current paradigm of diagnostic approaches. TTR for bronchoalveolar lavage (BAL) and endotracheal aspirate (ETA) specimens from hospitalized patients was evaluated using the Premier Healthcare Database, a comprehensive database of 194 U.S. hospitals. Times from specimen collection to reporting of organism ID/AST were evaluated and compared by specimen types and characteristics. A total of 79,662 (43,129 BAL; 36,533 ETA) specimens were included, of which 19.3% harbored no growth, 47.1% contained normal respiratory flora alone (including yeast), and 0.6% contained mycobacteria/molds. Potential bacterial pathogens (PBP) were recovered from 33.0%. ETA specimens had a higher proportion of specimens with isolation of PBP (39.2% versus 27.7%) and with normal respiratory flora (52.0% versus 43.0%) and were less likely to be negative (8.2% versus 28.6%) than BAL specimens (all P < 0.0001). Staphylococcus aureus and Pseudomonas aeruginosa were isolated in 10.5 and 6.4% of the specimens, respectively, and were the most common organisms identified. Median (interquartile range) TTR were 37.0 h (21.8 to 51.7 h) and 60.5 h (46.6 to 72.4 h) for ID and AST, respectively. Median TTR for major respiratory pathogens by organism ranged from 29.2 to 43.9 h for ID and from 47.9 to 73.9 h for AST. Organism type, specimen collection time, and hospital teaching status influenced TTR. Mechanically vented patients and ETA specimens were more likely to recover PBP.

中文翻译：

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在美国急诊医院进行支气管肺泡灌洗和气管内吸出标本的病原体鉴定和抗菌药敏测试的结果时间。

呼吸道病原体的鉴定（ID）和抗菌药敏测试（AST）对于管理肺炎以促进最佳抗生素治疗选择至关重要。很少有研究检查该关键标本的达到结果的时间（TTR），并且这些数据对于基准化当前诊断方法范式可能是有价值的。使用Premier Healthcare Database评估住院患者的支气管肺泡灌洗（BAL）和气管内吸出物（ETA）标本的TTR，该数据库是美国194家医院的综合数据库。从样本收集到报告生物ID / AST的时间进行了评估，并通过样本类型和特征进行了比较。总共包括79,662个（43,129 BAL; 36,533个ETA）标本，其中19.3％的标本没有增长，47个。1％仅包含正常呼吸道菌群（包括酵母），而0.6％仅包含分枝杆菌/霉菌。潜在细菌病原体（PBP）从33.0％回收。与BAL标本相比，ETA标本中分离PBP的标本比例更高（39.2％对27.7％），呼吸道菌群正常（52.0％对43.0％），阴性的可能性较小（8.2％对28.6％）P <0.0001）。分别在10.5％和6.4％的标本中分离出金黄色葡萄球菌和铜绿假单胞菌，它们是最常见的生物。ID和AST的中值（四分位数间距）TTR分别为37.0小时（21.8至51.7小时）和60.5小时（46.6至72.4小时）。生物体对主要呼吸道病原体的TTR中位数，ID范围为29.2至43.9小时，AST范围为47.9至73.9小时。生物体类型，标本采集时间和医院教学状况影响了TTR。机械通气的患者和ETA标本更有可能恢复PBP。