Assessment of Bronchial Lavage Samples For the Diagnosis of Childhood Pneumonia

Authors

  • Slobodanka Petrovic Medical Faculty, University of Novi Sad, Pediatrics, Novi Sad; Institute for Child and Youth Health Care of Vojvodina, Novi Sad
  • Svetlana Cegar Medical Faculty, University of Novi Sad, Pediatrics, Novi Sad; Institute for Child and Youth Health Care of Vojvodina, Novi Sad
  • Nenad Barisic Medical Faculty, University of Novi Sad, Pediatrics, Novi Sad; Institute for Child and Youth Health Care of Vojvodina, Novi Sad

DOI:

https://doi.org/10.3889/oamjms.2014.006

Keywords:

pneumonia, pharyngolaryngeal aspirate, bronchial lavage, lower respiratory tract infections, bronchoscopy.

Abstract

Background: Lower respiratory tract infections are frequent and often serious diseases in children. Wide number of microorganisms may cause lower respiratory tract infections, and sometimes it could be very difficult to determine the exact causative.

Aim: The aim of this study was to assess the reliability of specimens obtained by bronchial lavage in determining the etiology of childhood pneumonia.

Methods: This is prospective study conducted during four years period, in a group of 60 children aged from 6 months to 18 years. All patients included in this study underwent bronchoscopy when they fulfilled criteria of routine clinical protocol, in order to set correct diagnosis of lower respiratory tract disease. Results of bacteriological analysis of PLA samples were compared against the results of bacteriological analysis of BL samples of the same patient.

Results: In majority of subjects - 41 (68.32%), the bacteria isolated from the bronchial lavage samples was not identified in pharyngolaryngeal aspirate and was considered as the cause of infection. Haemophilus influenzae was the most frequently isolated pathogen in bronchial lavage samples.

Conclusion: Findings based on analysis of bronchial lavage samples may be used as reliable criterion for etiological diagnosis in cases of pneumonia when initial empirical treatment failed.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Harris M, Clark J, Coote N, et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011; 66(Suppl 2):ii1. DOI: https://doi.org/10.1136/thoraxjnl-2011-200598

Stein R, Marostica P. Community – Acquired Bacterial Pneumonia. In: Chernick V, editor. Kendig's Disorders of Respiratory tract in Children. 7th ed. Philadelphia: Elsevier. 2006. p 441-452 DOI: https://doi.org/10.1016/B978-0-7216-3695-5.50031-6

Lahti E, Peltola V, Waris M et al. Induced Sputum In Diagnosis Of Childhood Community Acquired Pneumonia. Thorax. 2009; 64(3): 252-257. DOI: https://doi.org/10.1136/thx.2008.099051

Masuda K, Masuda R, Nishi J. et al. Incidences of nasopharyngeal colonization of respiratory bacterial pathogens in Japanese children attending day-care centers. Pediatr Int. 2002; 44:376-380. DOI: https://doi.org/10.1046/j.1442-200X.2002.01587.x

Bogaert D, van Belkum A, Sluijter M et al. Colonisation by Streptococcus Pneumoniae and Staphylococcus Aureus in Healthy Children. Lancet. 2004; 363: 1871-1872. DOI: https://doi.org/10.1016/S0140-6736(04)16357-5

Doern GV, Heilmann KP, Huynh HK. et al. Antimicrobial Resistance Among Clinical Isolates of Streptococcus Pneumonia in the United States During 1999-2000. Including a Comparasion of Resistance Rates Since 1994.-1995. Antimicrob Agents Chemother. 2001; 45: 1721-1729. DOI: https://doi.org/10.1128/AAC.45.6.1721-1729.2001

Jacobs MR, Johnson CE. Macrolide resistance: An increasing concern of treatment failure in children. Pediatr Infect Dis J. 2003; 22(Suppl 8): S 131-138. DOI: https://doi.org/10.1097/00006454-200308001-00004

Baselskin VS, Wunderink RG. Bronchoscopic Diagnosis of Pneumonia. Clin Microbiol Rev. 1994; 7(4): 533-558. DOI: https://doi.org/10.1128/CMR.7.4.533

Budisin O, Sivcev J, Gusa N. Uporedjenje vrednosti dva naÄina obrade sputuma za kultivisanje u otkrivanju bakterijskih uzroÄnika obolenja donjih disajnih puteva. SaopÅ¡tenje. 1982; 1-2:40-44.

Bartlett RC. Medical Microbiology: Quality Cost and Clinical Relevance. New York: John Wiley and Sons, 1974.

Geckler RW, Gremillion DH, Mc Allister CK, Ellenbogen C. Microscopic And Bacteriological Comparasion Of Paired Sputum And Tracheal Aspirates. J Clin Microbiol. 1977; 6: 396-399. DOI: https://doi.org/10.1128/jcm.6.4.396-399.1977

George WL, Finegold SM. Bacterial Infections of The Lung. Chest,. 1982; 81: 502-7. DOI: https://doi.org/10.1378/chest.81.4.502

Berman SZ, Mathison DA, Stevenson DD, Tan EM, Vaughan JH. Trancbronchial Aspirations Studies In Astmatic Patients In Relapse With „Infective“ Asthma And In Subjects Without Respiratory Disease. J Allergy Clin Immunol. 1975; 56:205-214. DOI: https://doi.org/10.1016/0091-6749(75)90091-3

Wood A.Y,Davit A.J 2nd, Ciraulo D.L. et al. A prospective assessment of diagnostic efficacy of blind protective bronchial brushings compared to bronchoscope-assisted lavage, bronchoscope-directed brushings, and blind endotracheal aspirates in ventilator-associated pneumonia. J Trauma. 2003;55(5):825-34. DOI: https://doi.org/10.1097/01.TA.0000090038.26655.88

Meyer KC. Bronchoalveolar lavage as a diagnostic tool. Semin Respir Crit Care Med. 2007;28(5):546-60. DOI: https://doi.org/10.1055/s-2007-991527

Sachdev A, Chugh K, Sethi M, Gupta D, Wattal C, Menon G. Diagnosis of ventilator-associated pneumonia in children in resource-limited setting: a comparative study of bronchoscopic and nonbronchoscopic methods. Pediatr Crit Care Med. 2010;11(2): 258-66. DOI: https://doi.org/10.1097/PCC.0b013e3181bc5b00

Fagon J.Y, Chastre J, Wolff M, et al. Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial. Ann Intern Med. 2000;132(8):621-30. DOI: https://doi.org/10.7326/0003-4819-132-8-200004180-00004

Chastre J. Diagnosis and treatment of nosocomial pneumonia: bronchial fibroscopy, protected brushing and/or bronchial lavage is indispensable. Rev Pneumol Clin. 2001;57(2):113-23.

Chastre J, Trouillet J.L, Combes A, Luyt C.E. Diagnostic Techniques and Procedures for Establishing the Microbial Etiology of Ventilator-Associated Pneumonia for Clinical Trials: The Pros for Quantitative Cultures. Clin Infect Dis. 2010;51(Supp.1): S88-S92. DOI: https://doi.org/10.1086/653054

Fein AM, Feinsilver SH. Bronchoscopic Evaluation Of Nonresolving And Slowly Resolving Pneumonia. J Bronchol. 1994; 1(4): 309-320. DOI: https://doi.org/10.1097/00128594-199410000-00012

Godfrey S, Avital A, Maayan C, Rotchild M, Springer C. Yeld From Flexibile Bronchoscopy In Children . Pediatr Pulmonol. 1997; 23(4): 261-269. DOI: https://doi.org/10.1002/(SICI)1099-0496(199704)23:4<261::AID-PPUL3>3.0.CO;2-P

De Schutter I, De Wachter E, Crokaert F. et al. Microbiology of Bronchoalveolar Lavage Fluid in Children With Acute Nonresponding or Recurrent Community-Acquired Pneumonia: Identification of Nontypeable Haemophilus influenzae as a Major Pathogen. Clin Infect Dis 2011; 52(12): 1437-1444. DOI: https://doi.org/10.1093/cid/cir235

Downloads

Published

2014-03-15

How to Cite

1.
Petrovic S, Cegar S, Barisic N. Assessment of Bronchial Lavage Samples For the Diagnosis of Childhood Pneumonia. Open Access Maced J Med Sci [Internet]. 2014 Mar. 15 [cited 2024 Apr. 20];2(1):34-9. Available from: https://oamjms.eu/index.php/mjms/article/view/7

Issue

Section

B - Clinical Sciences

Categories