Koslow Matthew, Epstein Shochet Gali, Matveychuk Alona, Israeli-Shani Lilach, Guber Alexander, Shitrit David
Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, USA.
Pulmonary Medicine Department, Meir Medical Center, Kfar Saba, Israel.
J Thorac Dis. 2017 Dec;9(12):5300-5305. doi: 10.21037/jtd.2017.10.150.
Patients with lung cancer undergoing surgical and medical treatment are at increased risk for pulmonary complications. The importance of routine bronchoscopy procedure in populations with lung cancer has rarely been defined. We aimed to determine the growth of potentially pathogenic microorganisms (PPM) among patients evaluated by bronchoscopy for lung cancer.
This prospective study included 155 consecutive patients with lung mass or radiologic findings suspicious for malignancy. Baseline demographic, clinical and radiologic features were collected. Clinical features of infection were compared to microbiologic and histologic results.
The bacterial spectrum of lung cancer patients was similar to those without malignancy. The most frequently isolated organisms were and . Among all patients, bronchial bacterial positive PPM growth was noted in 30% (46/155). The significant PPM growth rate was three-fold higher among those with clinical signs of infection (P<0.001). Interestingly, 30 of these 46 patients (66%) did not show signs of clinical infection.
Bronchoscopic evaluations should include bacterial cultures for direct targeted antibiotic therapy only in the symptomatic patients.
接受手术和药物治疗的肺癌患者发生肺部并发症的风险增加。肺癌人群中常规支气管镜检查程序的重要性鲜有明确界定。我们旨在确定因肺癌接受支气管镜检查的患者中潜在致病微生物（PPM）的生长情况。
这项前瞻性研究纳入了155例连续的肺部有肿块或影像学表现可疑为恶性肿瘤的患者。收集了基线人口统计学、临床和影像学特征。将感染的临床特征与微生物学和组织学结果进行比较。
肺癌患者的细菌谱与无恶性肿瘤者相似。最常分离出的微生物是 和 。在所有患者中，30%（46/155）的患者支气管细菌PPM呈阳性生长。有感染临床体征的患者中显著PPM生长率高出三倍（P<0.001）。有趣的是，这46例患者中有30例（66%）没有临床感染迹象。
支气管镜评估仅应在有症状的患者中进行细菌培养，以进行直接靶向抗生素治疗。
