Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Infection. 2024 Aug;52(4):1481-1488. doi: 10.1007/s15010-024-02238-5. Epub 2024 Apr 8.
Bronchoalveolar lavage is commonly used in clinical practice for unresolved pneumonia. However, bronchoalveolar lavage is not suitable for all patients as it is an invasive procedure and can worsen oxygenation. The diagnostic value of bronchial wash and sputum has been debated extensively over the years. In this study, we aim to compare the diagnostic value in several pathogens of bronchoalveolar lavage and bronchial wash, and secondarily bronchoalveolar lavage and sputum.
We retrospectively included all adult patients in our hospital who underwent bronchoalveolar lavage, bronchial wash, and where sputum sampling was done between January 1st of 2018 and December 31st of 2021. The intraclass correlation coefficient was computed for the three tests.
In total, 308 patients were included. We found a level of correlation of 0.819 and 0.865, respectively, between bronchoalveolar lavage and bronchial wash for two pathogens: Staphylococcus aureus and Pseudomonas aeruginosa. For Stenotrophomonas maltophilia and Aspergillus fumigatus, we found an intraclass correlation coefficient of 0.568 and 0.624, respectively. Between bronchoalveolar lavage and sputum, we found varying levels of agreement.
Our study shows reasonably well agreement levels between bronchoalveolar lavage and bronchial wash, suggesting that bronchial wash could potentially be an alternative to bronchoalveolar lavage.
支气管肺泡灌洗常用于临床不明原因肺炎的诊治。然而，支气管肺泡灌洗并不适用于所有患者，因为它是一种有创性操作，可能会使氧合恶化。支气管冲洗和痰液的诊断价值多年来一直存在争议。在这项研究中，我们旨在比较支气管肺泡灌洗和支气管冲洗，以及支气管肺泡灌洗和痰液在几种病原体中的诊断价值。
我们回顾性纳入了 2018 年 1 月 1 日至 2021 年 12 月 31 日期间在我院接受支气管肺泡灌洗、支气管冲洗且同时进行痰标本采集的所有成年患者。计算了三种检测方法的组内相关系数。
共纳入 308 例患者。我们发现，对于金黄色葡萄球菌和铜绿假单胞菌这两种病原体，支气管肺泡灌洗和支气管冲洗之间的相关性水平分别为 0.819 和 0.865。对于嗜麦芽窄食单胞菌和烟曲霉，我们发现组内相关系数分别为 0.568 和 0.624。对于支气管肺泡灌洗和痰液之间，我们发现一致性程度不同。
我们的研究显示，支气管肺泡灌洗和支气管冲洗之间具有相当好的一致性水平，这表明支气管冲洗可能是支气管肺泡灌洗的替代方法。
