Kvale P A, Johnson M C, Wroblewski D A
Chest. 1979 Aug;76(2):140-2. doi: 10.1378/chest.76.2.140.
During a five-year period, cultures of bronchial washings for Mycobacterium tuberculosis were obtained almost routinely (859 of 1,012 bronchoscopic examinations.). This practice proved costly, and the diagnostic yield was extremely low. Only three cases were diagnosed solely by this method (0.35 percent). Five other cases were false-positive. Additionally, 39 patients with known active pulmonary tuberculosis had false-negative cultures of bronchial washings; 13 of these 39 patients were receiving antituberculosis drugs at the time of their bronchoscopic examinations. The inhibitory effect of local anesthetics upon the growth of M tuberculosis is the possible cause for the remaining 26 false-negative cultures. We conclude that bronchoscopic examination and culture of bronchial washings are not the best sources for diagnosis of pulmonary tuberculosis and that cultures of sputum and/or gastric washings are usually sufficient. The practice of obtaining routine cultures of bronchial washings in known pulmonary tuberculosis is of questionable value, when nearly two-thirds may be false-negative.
在五年期间，几乎常规地获取支气管灌洗样本进行结核分枝杆菌培养（1012例支气管镜检查中有859例）。这种做法成本高昂，且诊断率极低。仅通过这种方法确诊了3例（0.35%）。另外5例为假阳性。此外，39例已知患有活动性肺结核的患者支气管灌洗培养结果为假阴性；这39例患者中有13例在进行支气管镜检查时正在接受抗结核药物治疗。局部麻醉剂对结核分枝杆菌生长的抑制作用可能是其余26例假阴性培养结果的原因。我们得出结论，支气管镜检查和支气管灌洗培养并非诊断肺结核的最佳方法，痰液和/或胃灌洗培养通常就足够了。对于已知的肺结核患者，常规进行支气管灌洗培养的做法价值存疑，因为近三分之二的结果可能为假阴性。
