The Role of Bronchoalveolar Lavage in Diagnosing Nonopportunistic Bacterial Pneumonia (14)

In: Pulmonary function

6 May 2013

Microbiologic processing of the BAL fluid was different from other previously described methods, with quantitative cultures performed on a concentrated (tenfold) sample, and a threshold of 103 cfu/ml, similar to the one of PSB, was used. A significant growth was found in 72 percent of patients with each technique and in two of seven BAL in a control group (71 percent specificity). Agreement between BAL and PSB was 75 percent with respect to the type of organism recovered, but when concentration of organisms was also considered, it dropped to 56 percent. Cheap Diskus Advair
Chastre et al compared the results of BAL and PSB in a group of 18 ventilated patients who developed clinical manifestations of pneumonia, all of whom had not been receiving antibiotic therapy for at least ten days. A growth ^lO cfu/ml was seen in 80 percent of patients with pneumonia and in 31 percent of patients without lung infection. Moreover, microscopic analysis of the BAL was shown by this investigator to be important for the early recognition of pneumonia, before the results of quantitative bacterial cultures are available. In a group of 61 ventilated patients, intracellular organisms (ICO) were seen (using the May Grunwald-Giemsa stain) in 7 percent or more of the retrieved alveolar cells in 12 of 15 patients with pneumonia and in only 2 of 47 patients without pneumonia (96 percent specificity). Gram reaction of such bacteria closely correlated with the result of PSB bacterial culture.


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