For the presence or absence of VAP primarily based on clinical and radiological criteria (concordance of at least two out of 3 ICU physicians). Within the PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20719924 same day, tracheal aspirates have been collected aseptically and assayed for quantitative results with common approaches. The physicians were unaware with the culture results. Benefits: The 76 patients enrolled yielded 154 opportunities for evaluating the presence or absence of VAP. General concordance between ICU physicians was 94 and radiological criteria was the key purpose for discordance. There were 26 episodes of VAP (85 of concordance) as well as the important pathogens were P. aeruginosa (27 ) and S. aureus (23 ). Sensitivity, specificity, optimistic and unfavorable predictive values of qualitative and quantitative cultures of traqueal aspirates are shown within the table.Qualitative culture Sensitivity ( ) Specificity ( ) PPV ( ) NPV ( ) 92 11 17 88 105 cfu/ml 69 41 19 87 106 cfu/ml 26 76 19Conclusions: Primarily based on our preliminary benefits, quantification of tracheal aspirates for the objective of improving the diagnosis of VAP is useless and may not be cost-effective.PSpecific multigenotypic diagnosis of nosocomial pneumonia in ICUM Pirard*, P-F Laterre, M Bouyer, M Reynaert, J-L Gala* *Laboratory of Applied Acumapimod chemical information Molecular Technology, Universit?Catholique de Louvain, Belgium; Division of Intensive Care, St. Luc University Hospital, Belgium; Section MSW, Operational Epidemiology and Infections Ailments, Queen Astrid Military Hospital, Brussels, Belgium Mortality price of nosocomial pneumonia in ventilated ICU patients (pts) is about 20?5 . Regardless of advances in crucial care, normal criteria for pneumonia are nevertheless inaccurate. Antibiotherapy is normally started on a `best guess’ basis to anticipate regularly adverse bacteriological benefits (Ba-cul). Primary etiological pathogens are staphylococci, streptococci, pseudomonads and enterobacteriaceae. A multigenotypic and sequential molecular identification (Mol-id) was applied on bronchoalveolar lavages (BAL) from 12 pts with clinical-radiological evidence of infection with (n = 9)/without (n = 3) positive Ba-cul. DNA extraction and duplicate distinct amplification of 16S rDNA from BAL was initially made use of to determine signals corresponding to the presence of Gram + (G+), Gram ?(G?, or mixed G+/G? Any G+ signal was followed by femA and mecA multiplex (mpx)-PCR for species-specific identification of staphylococci and methicillin resistance, and by mpx-PCR for S. pneumoniae. Any G?signal was followed by mpx-PCR for species-specific identification of Pseudomonads (aeruginosa, cepacia, maltophilia) vs other G?for which the 16S rDNA amplicon was sequenced. Mol-id identified mixed G+/G?in 2/3 negative Ba-cul. Ba-cul gave G+ or G?only in three and 4/12 pts, respectively. Among these, Mol-id confirmed either G+ (2/3) or G?(2/4), and discovered a mixed signal in 3/7 pts. Mixed G+/G?was identified by Ba-cul and Mol-id in 2/12 BAL, but in 1 case, S. epidermidis was found by Mol-id and enterococci by Ba-cul. Staphylococci (MRSA, other) and Ps. aeruginosa had been located by Ba-cul and Mol-id in two and 3 pts, respectively. Present benefits suggest that Mol-id is often a helpful adjunct bringing additional insight to standard criteria of nosocomial pneumoniae in ICU and may be a timely relevant guide for antibiotherapy.SCritical CareVol 5 Suppl21st International Symposium on Intensive Care and Emergency MedicinePICU-acquired nosocomial infection: influence of delay in adequate antibiotic treatmentT Mathevon, B Souweine, O Traor?.