Respiratory Care: Chest Infections |

The Accuracy of BronkoTest in Detecting Bacterial Infection in Patients With Chronic Lung Diseases FREE TO VIEW

Ritaville Elorde, MD; Maria Encarnita Limpin
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Philippine Heart Center, Quezon City, Philippines

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1241A. doi:10.1016/j.chest.2016.08.1353
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SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To deterrmine the accuracy of BronkoTest in detecting bacterial infection in patients with chronic lung diseases.

METHODS: A prospective, cross sectional study involving 89 patients who were diagnosed with chronic lung diseases such as chronic obstructive pulmonary diseases (COPD) and bronchiectasis presenting with sputum production. A fresh sputum sample was obtained and simultaneously assessed by the doctor, patient, and nurse. Sputum samples were then compared with the colors of BronkoTest colour chart. Samples graded as 1 and 2 were reflected as mucoid sputum while Grades 3-5 were interpreted as purulent. Gram staining and culture were subsequently done.

RESULTS: A total of 89 patients participated in the study. Eighty five percent of the population consists of COPD patients and 15% with bronchiectasis. Fifty six patients had produced purulent sputum while 33 patients had mucoid sputum. Sixty per cent of patients were treated with inhaled corticosteroids and this was significantly associated with sputum purulence (pvalue=0.013). A higher rate (89%) of bacterial growth was found in purulent samples. The most common bacteria isolated were Klebsiella pneumonia and Pseudomonas aeruginosa. The accuracy of Bronkotest in detecting bacterial growth showed an 88.89% sensitivity, 63.6% specificity, positive predictive value of 71.43% and negative predictive value of 84.8%.

CONCLUSIONS: Assessing sputum color using BronkoTest can be used as a tool to determine the presence of bacterial infection in patients with chronic respiratory diseases presented with increasing sputum production.

CLINICAL IMPLICATIONS: Chronic lung diseases such as COPD and bronchiectasis are characterized by persistent cough, sputum production and recurrent lung infections which lead to the deterioration in quality of life. The presence of bacteria causing infection in the airways is associated with neutrophil recruitment and subsequent myeloperoxidase accumulation leading to yellow-green coloration of the sputum. However, purulence is a subjective term and the sputum color reported by patients is not reliable. Therefore, a sputum color chart such as BronkoTest can provide both patients and physicians a simple and noninvasive method to predict the presence of bacterial infection, hence, facilitating the need for and response to antibiotic therapy.

DISCLOSURE: The following authors have nothing to disclose: Ritaville Elorde, Maria Encarnita Limpin

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