JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2020, Vol. 40 ›› Issue (12): 1621-1626.doi: 10.3969/j.issn.1674-8115.2020.12.009

• Original article (Clinical research) • Previous Articles     Next Articles

Analysis of distribution and culture results of pathogens in sputum and bronchoalveolar lavage fluid from patients with pulmonary infection

QIN Rong1, 2, HE Ping1, ZHANG Yi-hao2, WANG Yan-chun3   

  1. 1. Department of Immunology and Microbiology, Shanghai Jiao Tong University College of Basic Medical Sciences, Shanghai 200025, China; 2. Department of Laboratory Medicine, Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine, Shanghai 201114, China; 3. Department of Laboratory Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, China
  • Online:2020-12-28 Published:2021-02-02
  • Supported by:
    National Natural Science Foundation of China (81971896).

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Abstract: Objective · To analyze the distribution of pathogens (fungi and bacteria) in sputum (SP) and bronchoalveolar lavage fluid (BALF) from patients with pulmonary infection, and explore the value of the two kinds of lower respiratory tract specimens in the diagnosis of clinical infection. Methods · The culture results of SP and BALF specimens from patients with pulmonary infection in the Department of Clinical Microbiology of Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine from January 2018 to June 2019 were retrospectively studied. The time interval between the two specimens was less than 24 h. Statistical description and consistency test were used to compare and analyze the distribution of pathogens between the two specimens. Results · Among the 313 patients with pulmonary infection, the positive rate of bacterial culture in BALF specimens was 27.55% (73/265) and that of fungal culture was 16.61% (49/295); the positive rate of bacterial culture in SP specimens was 25.38% (67/264), and that of fungal culture was higher [26.13% (75/287)]. From the positive culture of pathogens, the culture results of BALF and SP specimens were basically consistent. Based on the pathogens culture results of the 313 patients, the overall consistency rate of the qualitative results of BALF and SP specimens was 75.08% (235/313). Among them, the consistent rate of fungal detection was 79.09% (227/287) with significant consistency (P=0.000, Kappa=0.390), and the consistent rate of bacterial detection was 90.91% (240/264) with significant consistency (P=0.000, Kappa=0.767). Conclusion · Under certain conditions, SP culture should be given priority in clinical practice to avoid invasive examination of BALF. However, when SP culture results are not consistent with clinical judgment, especially in suspicious invasive pulmonary fungal infection, the BALF should be checked in time to identify the pathogenic infection.

Key words: bronchoalveolar lavage fluid (BALF), sputum (SP), bacterial culture, fungal culture

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