Wimberley N W, Bass J B, Boyd B W, Kirkpatrick M B, Serio R A, Pollock H M
Chest. 1982 May;81(5):556-62. doi: 10.1378/chest.81.5.556.
Fiberoptic bronchoscopy using a protected brush catheter was done in 65 patients with suspected pulmonary infections to obtain uncontaminated specimens for culture. Quantitative aerobic and anaerobic cultures were done on each specimen. Forty-one patients had pneumonia. Ten bacteremic patients had the same organisms recovered from the catheter and blood cultures. Seven patients had received antibiotics before the procedure, and cultures grew no organisms in high concentration. In 23 of 24 remaining patients probable pathogens were recovered in high concentrations, and specific therapy resulted in clinical improvement in all of these patients. Five patients with lung abscesses and seven with necrotizing pneumonia had mixed aerobic and anaerobic organisms recovered. Twelve patients had final diagnoses of nonbacterial lung disease, and cultures were negative or revealed low concentrations of organisms. Quantitative cultures were necessary in distinguishing pathogens from nonpathogens. There were no complications. The results of this study indicate that fiberoptic bronchoscopy using a special protected catheter is an accurate and safe technique for identification of etiologic agents in lower respiratory tract infections.
对65例疑似肺部感染患者进行了使用保护性毛刷导管的纤维支气管镜检查，以获取未受污染的标本进行培养。对每个标本进行了需氧菌和厌氧菌定量培养。41例患者患有肺炎。10例菌血症患者从导管培养物和血培养物中分离出相同的病原体。7例患者在检查前接受了抗生素治疗，培养物中未生长出高浓度的病原体。在其余24例患者中的23例中，培养出了高浓度的可能病原体，针对这些病原体的特异性治疗使所有这些患者的临床症状得到改善。5例肺脓肿患者和7例坏死性肺炎患者培养出了需氧菌和厌氧菌的混合菌。12例患者最终诊断为非细菌性肺部疾病，培养结果为阴性或显示病原体浓度较低。定量培养对于区分病原体和非病原体是必要的。未发生并发症。本研究结果表明，使用特殊保护性导管的纤维支气管镜检查是一种准确、安全的技术，可用于识别下呼吸道感染的病原体。
