Spraying a methylene blue marker in the posterior pharynx before the procedure, they demonstrated that passage of the bronchoscope resulted in the introduction of oropharyngeal contaminants into the suction channel of the instrument. Similar results have been reported by Fossieck et al in 31 clinically uninfected patients with lung cancer in whom bronchoscopic aspirates yielded 73 potential pathogens from 39 (87 percent) specimens. buy cipro
Moreover, bronchoscopy itself may cause contamination of the lower airways before obtaining samples of distal pulmonary secretions. Injection of lidocaine, through the bronchoscope, for topical anesthesia carries into the lung contaminants trapped in the suction channel, while splinting the vocal cords by the instrument favors aspiration of oral secretions. Even when the bronchoscopist follows a precise methodology in obtaining the specimen to minimize contaminating the tracheobronchial tree (no injection of lidocaine)9,H and the bronchoscope (avoid suctioning), a certain degree of contamination may not be avoided. Quantitative bacterial cultures of lower airway secretions have been used as a method to differentiate contaminants (low colony count) from bacteria causing infection (high colony count).
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