Abstract
Bronchoalveolar lavage (BAL) is the saline wash of the bronchial tree, which aids in diagnosing various pulmonary pathologies. The present study was contemplated with an aim to know the clinical, microbiological profile of BAL samples along with its sensitivity pattern and to assess its utility as a diagnostic tool. This was a prospective observational study, carried over 90 patients presenting with lower respiratory tract infections. The total microbial recovery rate from BAL was 39 (43.3%). The sensitivity, specificity and positive predictive value of BAL were found to be 76.4%, 89.7% and 90.6% respectively. Maximum isolates were bacteria (25.5%) followed by Mycobacterium tuberculosis (MTB) (16.6%) and fungi (1.1%). Predominant bacterial isolates were Gram-negative (81.5%) compared to Gram-positive (18.5%). Multidrug resistance (MDR) in bacteria was seen in 59.2% of isolates. BAL is a valuable diagnostic tool to find not only bacterial but mycobacterial and fungal infections in patients with lower respiratory tract infection (LRTI). A trend towards LRTI with Gram-negative infections is on the rise and they tend to be multidrug-resistant. Hence checking susceptibility patterns is crucial to start evidence-based treatment.
Highlights
Bronchoalveolar lavage (BAL) was introduced as a research-oriented procedure way back in 19701
The present study was contemplated with an aim to know the clinical, microbiological profile of BAL samples along with its sensitivity pattern and to assess its utility as a diagnostic tool
The inclusion criteria of the study were patients between 14 to 80 years of age presenting with symptoms of lower respiratory tract infection (LRTI) who were negative on sputum microscopy/culture and patients willing to participate in study
Summary
Bronchoalveolar lavage (BAL) was introduced as a research-oriented procedure way back in 19701. It was originally used as a tool for obtaining secretions and cells from the lower respiratory tracts of patients with interstitial, occupational, or both types of pulmonary diseases[2]. It was used for first time in India in 1994 for its important role in diagnosis of infections and malignancies[3]. Sputum samples are still considered effective in diagnosing infective lung conditions in our country, as they are easy to obtain They have 24% diagnostic yield, contamination of sample from oral flora during expectoration makes it unsatisfactory for culture[5]. The objective was to study the microbial profile of BAL samples, its utility as a diagnostic tool and to identify the divergent microbiota along with antimicrobial susceptibility pattern
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