Abstract
BackgroundPneumonia is a primary cause of morbidity and mortality in infectious disease, and increasing antimicrobial resistance has raised concerns of treatment failure. Therefore, we evaluated the value of a blood culture bottle for bronchoalveolar lavage (BAL) samples on pathogen identification and on treatment modification in patients with pneumonia.MethodsWe conducted a prospective study and enrolled 39 patients who were hospitalized for pneumonia. Enrolled patients underwent BAL; a 10-ml aliquot was transferred to a sterile container for standard quantitative culture, and a 5 ml aliquot was transferred to both an aerobic and an anaerobic blood culture bottle.ResultsMicrobes were detected in all 39 (100 %) specimens and possible pathogens were identified in 34 patients (84.6 %) from BAL blood culture bottles. In contrast, microbes were detected in 10 patients (25.6 %) and possible pathogens were isolated in 8 patients (20.5 %) in BAL fluid using conventional culture methods. Finally, 8 of 39 (20.5 %) patients changed antibiotics according to the BAL blood culture results and pneumonia improved in 6 of these patients.ConclusionsUsing blood culture bottles for BAL sampling in patients with pneumonia is a sensitive method to detect pathogens in order to identify an adequate antibiotic treatment regimen.
Highlights
Pneumonia is a primary cause of morbidity and mortality in infectious disease, and increasing antimicrobial resistance has raised concerns of treatment failure
If one or more possible pathogenic organisms were detected from the bronchoalveolar lavage (BAL) fluid in blood culture, we considered more likely pathogenic bacteria as the causative organisms
In BAL fluid conventional culture, no organisms or normal throat flora were grown in 29 patients (74.4 %), and a single microbe was detected by BAL fluid conventional culture in 10 patients (25.6 %)
Summary
Pneumonia is a primary cause of morbidity and mortality in infectious disease, and increasing antimicrobial resistance has raised concerns of treatment failure. Quick and effective antibiotic administration is key for successful treatment of pneumonia [2], increasing antimicrobial resistance has raised concerns regarding the failure of pneumonia treatment. If we can isolate the causative pathogens and identify their antibiogram, in hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP), which is a high-risk factor for drug-resistant pathogens, physicians could more select adequate antibiotics and improve treatment success rates. In order to diagnose an infection in sterile fluid such as ascites, pleural effusion, or joint fluid, use of a blood culture bottle is more sensitive than conventional culture methods to isolate pathogens [3,4,5,6]. Inoculating body fluid specimens immediately into the medium in blood culture bottle can improve survival of the microbes
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