Evaluation of Various Bronchoscopic Techniques to Diagnose the Cause of an Acute Exacerbation of Chronic Bronchitis

Abstract

Bacterial infection is a common cause of acute exacerbation of chronic bronchitis (AECB). Interest in identifying the causative agent has led us to evaluate the role and efficacy of invasive diagnostic tests for culture in patients with AECB. We performed bronchoscopy on 10 patients with AECB. During bronchoscopy, four samples were obtained for semiquantitative culture: endotracheal aspirate, protected specimen brush, bronchial lavage, and bronchoalveolar lavage. All four techniques identified potential pathogens in some patients. The protected brush specimen had the highest yield, with at least one organism at >100 colony forming units/mL of sample from all 10 patients. Of the 10 patients, 6 had recognized pathogens recovered by protected brush, whereas only three of these were detected by endotracheal aspirate or bronchial lavage. In comparing various invasive diagnostic techniques, protected brush specimens had the highest diagnostic yield. Journal of Bronchology7:221-225, 2000 AECB, acute exacerbations of chronic bronchitis; PSB, protected specimen brush; BAL, bronchoalveolar lavage; CFU, colony-forming units; BronL, bronchial lavage