Diagnostic Fiberoptic Bronchoscopy in Patients With Community-acquired Pneumonia (5)

Statistical Analysis
Results are expressed as mean ± SD. Quantitative cultures of BAL and TPC are compared by linear regression.
Results
In 28 (70 percent) of 40 cases of CAP studied, a definite etiology was confirmed by microbiologic methods. Results are shown in Table 1. Altogether, 31 microorganisms were cultured in significant counts; S pneumoniae (75 percent) and Haemophilus influenzae (21 percent) were the most frequent agents found (both agents in two cases).
Sputum Culture Results
Sputum cultures yielded S pneumoniae and H influenzae in nine (22 percent) and two (5 percent) cases, respectively. In all these cases the same organism was isolated in BAL culture, while TPC culture was positive in nine of them. In 18 (45 percent) cases, normal flora was obtained. In the remaining 12 (27 percent) cases, the patients were not able to expectorate or the sample was considered inadequate.
TPC and BAL Culture Results
The bacteria isolated in the TPC and BAL specimens are shown in Table 1. Remarkably, every time that TPC culture yielded a microorganism in pure culture, the same one was isolated from BAL sample. Accordingly, a qualitative agreement between TPC and BAL was achieved in nearly all cases. The exceptions were two cases of heavy BAL contamination with oral flora; in these cases, the bronchoscope was dislodged from the bronchus while performing BAL because of intense coughing. In none of the remaining cases was normal flora obtained.

Table 1—Bacteriology; Bewdts of Sputum, TPC, and BAL Cultures m 40 Cases of CAP

Category: Pulmonary disease

Tags: Bronchoscopy, etiology, normal flora, pneumonia