The Role of Bronchoalveolar Lavage in Diagnosing Nonopportunistic Bacterial Pneumonia (8)

In: Pulmonary function

30 Apr 2013

Immunosuppressed Batient
In a large study of patients undergoing bronchoscopy, Kahn and Jones showed that the recovery of more than 1 percent squamous epithelial cells (SEC) in the cytocentrifugated BAL specimen (May Grun-wald-Giemsa stain) was an accurate predictor of heavy contamination by oropharyngeal flora. In 57 patients (39 study, 18 control) without bacterial pneumonia or bronchitis, a total of 76 bacterial isolates were recovered in the BAL. Seventeen patients (30 percent) had ^1 percent SEC. In this group, 12 of 28 isolates grew above the diagnostic threshold of 105 cfu/ml compared with only 4 of 48 isolates in patients with ^1 percent SEC. birth control yasmin

Bacterial pneumonia was diagnosed in 13 (22 percent) of 57 immunosuppressed patients presenting with fever and infiltrates; seven patients had received antibiotics for one to seven days. Bronchoalveolar lavage with low contamination (^1 percent SEC) grew at least one microorganism above the threshold of 105 cfu/ml. However, BAL could not discriminate pneumonia from bronchitis; three of five patients with acute bacterial bronchitis had significant growth (^10* cfu/ ml). Concurrent quantitative cultures of BAL and PSB in 13 patients showed a reasonable correlation, with BAL specimens yielding numbers of cfu/ml 0.5 loglO higher than those of PSB.


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