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Chest Infections |

The Relative Yield of Bronchial Washings Versus Bronchoalveolar Lavage for Various Microorganisms

Adam Dost*, DO; David Bland, MD
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Loma Linda University Medical Center, Loma Linda, CA


Chest. 2012;142(4_MeetingAbstracts):229A. doi:10.1378/chest.1388139
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Abstract

SESSION TYPE: ICU Infections

PRESENTED ON: Wednesday, October 24, 2012 at 02:45 PM - 04:15 PM

PURPOSE: Microbiological studies are commonly performed on BW and BAL to help diagnose pneumonia. However, there is limited information about the yield of BW versus BAL. The purpose of this study was to compare the yield of BW and BAL for various organisms.

METHODS: We reviewed 494 consecutive bronchoscopies performed on patients aged 18 - 90 years between 1/1/2011 - 7/20/2011. For patients undergoing multiple bronchoscopies, only the first procedure was included. Subjects who had at least one common microbiologic test done on BW and BAL were included in the study. The study was IRB approved with waiver of informed consent.

RESULTS: 97 cases met entry criteria with a mean age of 55.1 years, 57% female, 81% inpatients and 28% with DM. Aerobic cultures: 44 % of BW and 29% of BAL yielded potentially pathogenic organisms. Of the 73 cases that had both BW and BAL submitted for aerobic culture, 56% were concordant with both BW and BAL respiratory cultures negative. 22% were concordant positive with both BW and BAL isolating the same micro-organism(s). 18% were discordant with positive cultures for BW but negative for BAL. 4% were discordant with negative BW culture but positive for BAL. Fungal culture: 58 % of BW and 44% of BAL yielded fungus/yeast. Of 88 cases, 33% were concordant with both BW and BAL positive for the same organism. 3% were discordant with different organism(s) in BW and BAL. 24 % were discordant with positive fungal culture in BW but negative in BAL. 8 % were discordant with negative BW and positive BAL fungal culture. AFB: 8 % of BW and 5% of BAL yielded AFB. 4 cases had positive AFB cultures on both BW and BAL. Viral culture: BW and BAL both had a 13% yield for viral growth.

CONCLUSIONS: BW provided equal or higher yield than BAL for pathogenic bacteria, fungi, AFB and viruses. However, BAL occasionally identified a microorganism missed by BW.

CLINICAL IMPLICATIONS: The purpose of this study was to compare the yield of BW and BAL for various organisms.

DISCLOSURE: The following authors have nothing to disclose: Adam Dost, David Bland

No Product/Research Disclosure Information

Loma Linda University Medical Center, Loma Linda, CA

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