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Journal of Clinical Microbiology, June 2000, p. 2117-2121, Vol. 38, No. 6
Departments of Medical
Microbiology1 and
Pulmonology,2 University Hospital
Maastricht, Maastricht, The Netherlands
Received 12 November 1999/Returned for modification 9 January
2000/Accepted 21 March 2000
Quantitative cultures of bronchoalveolar lavage (BAL) fluid are
important in the diagnosis of ventilator-associated pneumonia, and
calibrated loops are commonly used to set up these cultures. In this
study, the performances of calibrated 0.010- and 0.001-ml loops in the
transfer of BAL fluid were determined. Five loops of one lot from seven
manufacturers were tested. Calibrations were performed by the
gravimetric method (0.010-ml loops) and the colorimetric method
(0.001-ml loops). Most of the 0.010-ml loops displayed a precision that
was less than 10%, but six of them showed very poor accuracies as they
transferred a deficiency (nichrome loops) or an excess (disposable
loops) of BAL fluid that exceeded ±10%. The mean maximum and minimum
BAL fluid volumes delivered by the 0.010-ml loops differed by a factor
3. The 0.001-ml loops displayed acceptable precision. Five of them
showed inaccuracies of
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Accuracy and Precision of Quantitative Calibrated
Loops in Transfer of Bronchoalveolar Lavage Fluid
±10%, and mean maximum and minimum BAL fluid
volumes had a range of a factor of 2. For all loops, the volumes of BAL
fluid sampled were larger than the volumes of reagent-grade water
sampled. Results of the colony counting experiments confirmed these
findings and revealed a high intra-assay variability for the 0.001-ml
loops. We conclude that, when BAL fluid samples are cultured with
calibrated loops, (i) proper verification of the calibration of these
loops is mandatory, (ii) calibrations should be performed with BAL
fluid as the test solution, and (iii) borderline quantitative culture results should be interpreted with knowledge of the inaccuracy values
of these loops.
*
Corresponding author. Mailing address: Department of
Medical Microbiology, University Hospital of Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Phone: 31-43-387 46 44. Fax: 31-43-387 66 43. E-mail: JJA{at}ms-azm-3.azm.nl.
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