Gu Kang Mo, Kang Hye Rin, Park Jimyung, Kwak Nakwon, Yim Jae Joon
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
J Korean Med Sci. 2021 Aug 9;36(31):e202. doi: 10.3346/jkms.2021.36.e202.
Bronchoscopy is recommended for patients with suspected nontuberculous mycobacterial pulmonary disease (NTM-PD) whose sputum culture results are consistently negative or from whom adequate sputum samples cannot be obtained. Post-bronchoscopy sputum (PBS) collection is recommended for patients with suspected tuberculosis who undergo bronchoscopy. However, it remains unclear whether PBS collection can increase the diagnostic yield of NTM-PD.
Patients with suspected NTM-PD who underwent diagnostic bronchoscopy from January 1, 2017 to June 30, 2020 at the Seoul National University Hospital were included in the study. They were divided into the sputum culture-negative and scanty sputum groups. The results of mycobacterial cultures from bronchial washing specimens and PBS were compared between these groups.
In total, 141 patients were included in the study; there were 39 and 102 patients in the sputum culture-negative and scanty sputum groups, respectively. Nontuberculous mycobacteria were cultured from bronchial washing specimens collected from 38.3% (54/141) of all patients (30.7% [12/39] patients in the sputum culture-negative group and 41.2% [42/102] patients in the scanty sputum group; = 0.345). Nontuberculous mycobacteria were exclusively cultured from PBS collected from 3.5% (5/141) of all patients (7.7% [3/39] patients in the sputum culture-negative group and 2.0% [2/102] patients in the scanty sputum group; = 0.255).
Additional PBS collection improved diagnostic yield marginally in patients with suspected NTM-PD who undergo bronchoscopy.
对于痰培养结果持续阴性或无法获取足够痰液样本的疑似非结核分枝杆菌肺病（NTM-PD）患者，推荐进行支气管镜检查。对于接受支气管镜检查的疑似结核病患者，推荐采集支气管镜检查后痰液（PBS）。然而，PBS采集是否能提高NTM-PD的诊断率仍不清楚。
纳入2017年1月1日至2020年6月30日在首尔国立大学医院接受诊断性支气管镜检查的疑似NTM-PD患者。将他们分为痰培养阴性组和痰液稀少组。比较两组支气管冲洗标本和PBS的分枝杆菌培养结果。
本研究共纳入141例患者；痰培养阴性组和痰液稀少组分别有39例和102例患者。在所有患者中，38.3%（54/141）的患者支气管冲洗标本培养出非结核分枝杆菌（痰培养阴性组为30.7%[12/39]，痰液稀少组为41.2%[42/102]；P = 0.345）。仅在3.5%（5/141）的患者PBS中培养出非结核分枝杆菌（痰培养阴性组为7.7%[3/39]，痰液稀少组为2.0%[2/102]；P = 0.255）。
对于接受支气管镜检查的疑似NTM-PD患者，额外采集PBS仅略微提高了诊断率。
