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Journal of Clinical Microbiology, June 2000, p. 2117-2121, Vol. 38, No. 6
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

J. A. Jacobs,1,* E. I. G. B. De Brauwer,1 E. I. M. Cornelissen,1 and M. Drent2

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 <= ±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.


Journal of Clinical Microbiology, June 2000, p. 2117-2121, Vol. 38, No. 6
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.



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