Kahn F W, Jones J M
Research Service, Middleton Veterans Administration Hospital, Madison, Wisconsin.
J Clin Microbiol. 1988 Jun;26(6):1150-5. doi: 10.1128/jcm.26.6.1150-1155.1988.
Several studies have concluded that bronchoalveolar lavage (BAL) is a useful technique for diagnosing pulmonary disease in immunocompromised patients, but implementation of a protocol for obtaining, processing, and analyzing BAL specimens in a clinical microbiology laboratory has not been reported. We determined the utility of a laboratory protocol by analyzing 100 BAL specimens from 94 immunocompromised patients. Each BAL specimen was cultured quantitatively for bacteria. A concentrate of each specimen was cultured for fungi, viruses, mycobacteria, and Legionella sp. Slides of the BAL concentrate were prepared by cytocentrifugation and stained by a number of histochemical and fluorescence techniques. Overall diagnostic yields of 81% for infections, 90% for hemorrhage, and 13% for neoplasms were obtained with the patients studied. BAL analysis was incapable of diagnosing drug- or radiation-induced pneumonitis or idiopathic interstitial pneumonitis. After evaluation of the protocol was completed, it was successfully implemented in two university-based clinical microbiology laboratories as a routine diagnostic service.
多项研究得出结论，支气管肺泡灌洗（BAL）是诊断免疫功能低下患者肺部疾病的一种有用技术，但尚未有关于在临床微生物实验室获取、处理和分析BAL标本的方案实施的报道。我们通过分析94例免疫功能低下患者的100份BAL标本，确定了实验室方案的实用性。每份BAL标本均进行细菌定量培养。每份标本的浓缩物用于培养真菌、病毒、分枝杆菌和军团菌属。通过细胞离心法制备BAL浓缩物涂片，并用多种组织化学和荧光技术染色。在所研究的患者中，感染的总体诊断率为81%，出血为90%，肿瘤为13%。BAL分析无法诊断药物或辐射引起的肺炎或特发性间质性肺炎。在完成对该方案的评估后，它作为一项常规诊断服务在两家大学附属医院的临床微生物实验室成功实施。
