New bacterial growth in bronchial secretions after bronchoscopic valve implantation

Abstract

Backgroud: Bronchoscopic valve implantation is an established treatment in selected patients with severe lung emphysema. There is evidence in literature of increased bacterial colonization of various implants. Is this the case also after valve implantation? Methods: Retrospective analysis of 68 patients with examination of the bronchial secretions for presence or change of bacterial growth before and after valve implantation. Results: Out of the 68 patients only 5 (7%) presented with evidence of bacterial colonization and the rest (n=63) showed no bacterial growth at baseline. In 42 out of the 63 patients (66%) was new bacterial growth observed after valve implantation and this growth correlated with the time elapsing after the implantation. Patients who had valves implanted for up to one year did not show any new bacterial growth until the explantation. On the contrary, patients who had valves implanted for periods longer than a year did show new bacterial growth. Of importance was the observation that almost half (48%) of the patients who presented a new bacterial growth had evidence of viridans streptococci, Rothia muccilaginosa, Neisseria species and anaerobic bacteria simultaneously. Other colonizing organisms recorded were Staphylococcus aureus (17%) Stenotrophomonas maltophilia (13%), Moraxella catarrhalis (11%) and Pseudomonas aeruginosa (8%). For all of the 5 patients who presented with initial bacterial colonization was a change in the flora evident after the implantation. Conclusion: In this study we observed an increased bacterial colonization in the long term after valve implantation. This finding needs further elucidation regarding its possible clinical relevance.