Guerra and Baughman obtained BAL for quantitative bacterial culture at one dilution in 54 patients receiving mechanical ventilation who underwent bronchoscopy for clinical pneumonia (30 patients) or a noninfectious process (24 patients). In the pneumonia group, nine patients had an opportunistic infection and three had either Legionella or Mycobacterium tuberculosis. The remaining 18 patients were believed to have bacterial pneumonia. Using a diagnostic threshold of 104 cfu/ml, a significant growth was seen in 16 patients (89 percent) with pneumonia and in none of those without. Seventy percent of patients with pneumonia were receiving antimicrobials and none of the significant organisms (^lO cfu/ml) was sensitive to the administered antibiotic. Seventy-five percent of patients in the control group were receiving antimicrobials, and this treatment was discontinued after results of cultures were available. proventil inhaler
Diagnostic Value of BAL
In summary, BAL samples a larger and more representative volume of respiratory secretions than PSB, and its value in the rapid identification of patients with bacterial pneumonia and in directing antimicrobial therapy has been recently recognized.
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