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The impact on community acquired pneumonia empirical therapy of diagnostic bronchoscopic techniques.
Scand J Infect Dis. 2008; 40(4):286-92.SJ

Abstract

The aim of the present study was to examine the modification of initial empirical treatment based on the microbiological results of bronchoscopic techniques after comparing the diagnostic yield of protected specimen brush (PSB) and bronchoalveolar lavage (BAL) in the immunocompetent patient with community acquired pneumonia (CAP) with results obtained from conventional sputum cultures. 88 patients with presumptive diagnosis of CAP necessitating hospitalization were prospectively studied. Fibreoptic bronchoscopy with quantitative PSB and BAL cultures for common pathogens, mycobacteria and fungi was performed. Conventional sputum cultures were also obtained. PSB and BAL quantitative cultures added 26.1% and 36.4%, respectively, more microbiological documentation for CAP compared to conventional sputum cultures (p < 0.0001). Gram staining was indicative of the pathogen mostly in cases where Streptococcus pneumoniae was isolated, which was also the most frequently isolated pathogen (19.3%), followed by Haemophilus influenzae (9%). M. tuberculosis was isolated in 6.8% of patients. Modification of treatment ensued in 27.3% of patients because of the application of the cultures of sputum and invasive technique. PSB and BAL added significant information to the aetiological diagnosis of hospitalized immunocompetent patients with CAP.

Authors+Show Affiliations

Fourth Department of Internal Medicine, University General Hospital 'ATTIKON', Athens, Greece. fmanali@otenet.grNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

17918018

Citation

Manali, Effrosyni, et al. "The Impact On Community Acquired Pneumonia Empirical Therapy of Diagnostic Bronchoscopic Techniques." Scandinavian Journal of Infectious Diseases, vol. 40, no. 4, 2008, pp. 286-92.
Manali E, Papadopoulos A, Tsiodras S, et al. The impact on community acquired pneumonia empirical therapy of diagnostic bronchoscopic techniques. Scand J Infect Dis. 2008;40(4):286-92.
Manali, E., Papadopoulos, A., Tsiodras, S., Polychronopoulos, V., Giamarellou, H., & Kanellakopoulou, K. (2008). The impact on community acquired pneumonia empirical therapy of diagnostic bronchoscopic techniques. Scandinavian Journal of Infectious Diseases, 40(4), 286-92.
Manali E, et al. The Impact On Community Acquired Pneumonia Empirical Therapy of Diagnostic Bronchoscopic Techniques. Scand J Infect Dis. 2008;40(4):286-92. PubMed PMID: 17918018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact on community acquired pneumonia empirical therapy of diagnostic bronchoscopic techniques. AU - Manali,Effrosyni, AU - Papadopoulos,Antonios, AU - Tsiodras,Sotirios, AU - Polychronopoulos,Vlasis, AU - Giamarellou,Helen, AU - Kanellakopoulou,Kyriaki, PY - 2007/10/6/pubmed PY - 2008/9/9/medline PY - 2007/10/6/entrez SP - 286 EP - 92 JF - Scandinavian journal of infectious diseases JO - Scand J Infect Dis VL - 40 IS - 4 N2 - The aim of the present study was to examine the modification of initial empirical treatment based on the microbiological results of bronchoscopic techniques after comparing the diagnostic yield of protected specimen brush (PSB) and bronchoalveolar lavage (BAL) in the immunocompetent patient with community acquired pneumonia (CAP) with results obtained from conventional sputum cultures. 88 patients with presumptive diagnosis of CAP necessitating hospitalization were prospectively studied. Fibreoptic bronchoscopy with quantitative PSB and BAL cultures for common pathogens, mycobacteria and fungi was performed. Conventional sputum cultures were also obtained. PSB and BAL quantitative cultures added 26.1% and 36.4%, respectively, more microbiological documentation for CAP compared to conventional sputum cultures (p < 0.0001). Gram staining was indicative of the pathogen mostly in cases where Streptococcus pneumoniae was isolated, which was also the most frequently isolated pathogen (19.3%), followed by Haemophilus influenzae (9%). M. tuberculosis was isolated in 6.8% of patients. Modification of treatment ensued in 27.3% of patients because of the application of the cultures of sputum and invasive technique. PSB and BAL added significant information to the aetiological diagnosis of hospitalized immunocompetent patients with CAP. SN - 0036-5548 UR - https://www.unboundmedicine.com/medline/citation/17918018/The_impact_on_community_acquired_pneumonia_empirical_therapy_of_diagnostic_bronchoscopic_techniques_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365540701663373 DB - PRIME DP - Unbound Medicine ER -