Comparison of protected and conventional telescopic bronchial aspirate in the study of pulmonary infections

Objectives:

Evaluate the yield of protected telescopic bronchial catheter and compare it with conventional bronchial aspirate in patients subjected to bronchoscopy for bacteriological diagnosis.

Material and methods:

Retrospective study of 45 consecutive patients who underwent a bronchoscopy during which protected telescopic bronchial catheter (Combicath®) and later conventional bronchial aspirate were administered. The variables, sex, requesting service, indication for bronchoscopy, radiology and the existence of immunosuppression were evaluated.

Results:

A total of 45 patients were evaluated between February 2016 and August 2017. The average age was 59.2 (24 – 80). Thirty-three per cent (33.3%) of the patients (15) were immunosuppressive, of which four carried HIV. The most common radiological pattern was localised, with 28 patients (62.2%), and a diffuse pattern affected the rest. The majority, 39 patients (86.7%), had or were receiving antibiotic treatment. The most frequent indications for bronchoscopy were: 40% pulmonary infiltrates; 15.6% pneumonia; 13.3% suspected tuberculosis; and 11.5% slowly resolving pneumonia. Conventional bronchial aspirate was positive in 13 patients (28.9%) and the isolated micro-organisms were Pseudomona aeruginosa in three patients (6.7%), Klebsiella pneumoniae in two (4.4%), Mycobacterium tuberculosis in two (4.4%) and polymicrobial in two other cases. The four remaining cases corresponded to isolates of Pneumococcus, Candida, Aspergillus and Pneumocytis. The samples taken through protected telescopic bronchial aspirate (Combicath®) were positive for the isolation of some micro-organism in 9 patients (20%), with the isolates corresponding to three cases of Pneumococcus, two cases of Pseudomona, one case of Klebsiella, one case of Staphylococcus and two polymicrobial cases.

Conclusions:

The diagnostic yield of the bronchoscopic bacteriological samples is low in our sample and does not increase with protected bronchial suction.