Microbiological profile of bronchoalveolar lavage fluid in patients with chronic respiratory diseases: a tertiary care hospital study

Abstract Background There are limited data in real clinical practice on the diagnostic value of BAL (bronchoalveolar lavage) fluid galactomannan (GM) assay in patients with suspected invasive pulmonary aspergillosis (IPA) who had negative serum GM results. Methods This study was performed at Asan Medical Center, a 2700 bed tertiary-care hospital in Seoul, South Korea between May 2008 and April 2019. All patients with suspected IPA whose serum GM assays revealed negative results and sequentially underwent BAL were enrolled in this study. Patients were classified as proven, probable, possible or not IPA by the revised 2019 EORTC/MSG definition. Results A total of 341 patients with suspected IPA including 4 proven IPA, 38 probable IPA, 107 possible IPA, and 192 not IPA were enrolled. Of these 341 patients, 107 (31%) with possible IPA were excluded from the final analysis. Of 42 patients with proven or probable IPA who had initial negative serum GM results, 24 (57%) revealed positive BAL GM results (n=24) or BAL fungal culture (n=8). Among the remaining 18 (43%), 2 (5%) were diagnosed as proven IPA by the histopathologic exam from transbronchial lung biopsy, 6 (14%) as probable IPA by subsequent sputum fungal culture, and 10 (24%) as probable IPA by repeated serum GM assay after BAL. Of 192 patients with not IPA, 14 (7%) revealed positive BAL GM results (n=14) or BAL fungal culture (n=8). The diagnostic performance of various tests is shown in Table 1. Table 1. Diagnostic performance of various diagnostic tests in patients with suspected IPA who had negative serum GM results Conclusion Sequential BAL in patients with suspected IPA who had initial negative serum GM results provided additional diagnostic yield in about half of patients. Disclosures All Authors: No reported disclosures

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Device-associated infection rates with microbiological profile and antibiogram pattern from an adult medical-surgical ICU of a tertiary care hospital

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2016.02.661 ◽

2016 ◽

Vol 45 ◽

pp. 300

Author(s):

B. Kashyap ◽

S. Gupta ◽

Y. Sarin

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Infection Rates ◽

Microbiological Profile ◽

Surgical Icu ◽

Device Associated Infection

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Inter-laboratory comparison of three different real-time PCR assays for the detection of Pneumocystis jiroveci in bronchoalveolar lavage fluid samples

Journal of Medical Microbiology ◽

10.1099/jmm.0.46552-0 ◽

2006 ◽

Vol 55 (9) ◽

pp. 1229-1235 ◽

Cited By ~ 40

Author(s):

Catharina F. M. Linssen ◽

Jan A. Jacobs ◽

Pieter Beckers ◽

Kate E. Templeton ◽

Judith Bakkers ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Real Time ◽

Real Time Pcr ◽

Bronchoalveolar Lavage Fluid ◽

Medical Center ◽

Tertiary Care ◽

Lavage Fluid ◽

The Other ◽

Pneumocystis Jiroveci ◽

Pcr Assays

Pneumocystis jiroveci pneumonia (PCP) is an opportunistic infection affecting immunocompromised patients. While conventional diagnosis of PCP by microscopy is cumbersome, the use of PCR to diagnose PCP has great potential. Nevertheless, inter-laboratory validation and standardization of PCR assays is lacking. The aim of this study was to evaluate the inter-laboratory agreement of three independently developed real-time PCR assays for the detection of P. jiroveci in bronchoalveolar lavage fluid samples. Therefore, 124 samples were collected in three tertiary care laboratories (Leiden University Medical Center, Maastricht Infection Center and Radboud University Nijmegen Medical Centre) and were tested by both microscopy and real-time PCR. Of 41 samples positive for P. jiroveci by microscopy, 40 were positive in all three PCR assays. The remaining sample was positive in a single assay only. Out of 83 microscopy-negative samples, 69 were negative in all three PCR assays. The other 14 samples were found positive, either in all three assays (n=5), in two (n=2) or in one of the assays (n=7). The data demonstrate high inter-laboratory agreement among real-time PCR assays for the detection of P. jiroveci.

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