Akurasi Kultur Sekret Trakea Dibandingkan dengan Kultur BAL pada Pasien Ventilator Associated Pneumonia yang Mendapat Mekanik Ventilasi Invasif di IPI RSUP HAM

Abstract

Background: Ventilator-associated pneumonia (VAP) is a critical complication that commonly affects patients who are admitted to intensive care units (ICU) and undergo mechanical ventilation. Accurate and timely diagnosis is essential to ensure appropriate treatment and improve patient outcomes. Among various diagnostic methods, tracheal secretion culture and bronchoalveolar lavage (BAL) culture are frequently used to identify the pathogens responsible for VAP. Aim: This study aims to compare the diagnostic accuracy of tracheal secretion culture and BAL culture, the latter considered the gold standard, in detecting VAP in ICU patients at Haji Adam Malik General Hospital in 2024. Materials and Methods: An analytical observational design was employed, involving ICU patients diagnosed with VAP. Culture results from tracheal secretion and BAL were compared to assess their sensitivity and specificity. Data were analyzed to determine which diagnostic method is more reliable for VAP detection. Results: Tracheal secretion culture demonstrated higher sensitivity but lower specificity compared to BAL culture. While tracheal secretion culture is easier, less invasive, and more accessible, its higher risk of contamination from upper airway flora led to more false positives. On the other hand, BAL culture, though more invasive and technically challenging, provided more accurate pathogen identification. Conclusion: The choice of diagnostic method should consider a balance between diagnostic accuracy, procedural safety, and available resources to optimize treatment outcomes for patients with VAP. Further research could help refine diagnostic strategies and improve patient care in the ICU setting.