Quantitative culture of bronchoalveolar lavage fluid for the diagnosis of bacterial pneumonia

David E. Cantral, Thomas G. Tape, Elizabeth C. Reed, John R. Spurzem, Stephen I. Rennard, Austin B. Thompson

Research output: Contribution to journalArticle

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Abstract

purpose: A prospective study to determine the usefulness of quantitative bacterial cultures of fluid obtained via fiberoptic bronchoscopy and bronchoalveolar lavage as an aid in the diagnosis of bacterial pneumonia. patients and methods: All patients undergoing fiberoptic bronchoscopy with bronchoalveolar lavage during a 6 1 2-month period. Presence of pneumonia was determined using clinical, radiographic, laboratory, and histologic data. Quantitative bacterial cultures of bronchoalveolar lavage fluid were determined using a 1-μL culture loop. results: Quantitative bacterial cultures of bronchoalveolar lavage (BAL) fluid were sensitive and specific predictors of bacterial pneumonia. Using 103 colony-forming units (cfu)/mL as the threshold value for a positive culture, we determined the sensitivity and specificity to be 90% and 97%, respectively. The data were also analyzed for the subgroups of patients who were intubated or were receiving antibiotics. The sensitivity and specificity were 78% and 96% for the group of patients receiving antibiotics and 100% and 82% for the group of patients intubated for more than 24 hours at the time of BAL. Values for the area under the receiver operating characteristic curve for the 3 groups were 0.94, 0.88, and 0.96, respectively. conclusions: Quantitative bacterial cultures of BAL fluid are sensitive and specific in the diagnosis of bacterial pneumonia. The use of antibiotics at the time of BAL reduces the sensitivity of the test, and prolonged intubation reduces the specificity of the test.

Original languageEnglish (US)
Pages (from-to)601-607
Number of pages7
JournalThe American journal of medicine
Volume95
Issue number6
DOIs
StatePublished - Dec 1993

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Bacterial Pneumonia
Bronchoalveolar Lavage Fluid
Bronchoalveolar Lavage
Bronchoscopy
Anti-Bacterial Agents
Sensitivity and Specificity
Intubation
ROC Curve
Pneumonia
Stem Cells
Prospective Studies

ASJC Scopus subject areas

  • Medicine(all)

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Quantitative culture of bronchoalveolar lavage fluid for the diagnosis of bacterial pneumonia. / Cantral, David E.; Tape, Thomas G.; Reed, Elizabeth C.; Spurzem, John R.; Rennard, Stephen I.; Thompson, Austin B.

In: The American journal of medicine, Vol. 95, No. 6, 12.1993, p. 601-607.

Research output: Contribution to journalArticle

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AU - Rennard, Stephen I.

AU - Thompson, Austin B.

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