Bacteriologic Strategy

• Uses quantitative culture of endotracheal aspirates, bronchoalveolar lavage (BAL), or protected specimen brush (PSB)

• Greater than or equal to 106 cfu/mL for endotracheal aspirates

• Greater than or equal to 104 to 105 cfu/mL for BAL

• Greater than or equal to 10 cfu/mL for PSB

• The advantage of this method is that it separates colonization from infection better than culturing tracheal aspirates

• The limitation is the potential misinterpretation of negative culture results. These samples should be obtained prior to antibiotics being started

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