This study supports the use of endotracheal aspirate (ETA) as a cost-effective and efficient alternative to mBAL for the diagnosis of pneumonia in intubated ICU patients, particularly in settings where resources are limited.

While ETA offers a practical solution in many clinical scenarios, its limitations must be recognized, and clinicians should remain vigilant in cases where the diagnosis of pneumonia is uncertain.

Further studies are recommended to validate these findings across diverse patient populations and clinical settings, and to explore the impact of diagnostic methods on patient outcomes.

Out of 120 patients, 112 paired samples were analyzed. ETA exhibited a sensitivity of 81.1%, specificity of 92.1%, PPV of 95.2%, and NPV of 71.4%, with an overall accuracy of 84.8%.

The most commonly isolated pathogens were Acinetobacter and Klebsiella. No serious adverse events occurred.

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