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Usefulness of Bronchoscopic Microsampling To Detect the Pathogenic Bacteria of Respiratory Infection^*

^* From the Departments of Pulmonary and Infectious Diseases (Drs. Sasabayashi, Tsushima, and Hatayama), Endoscopy (Dr. Yamazaki), and Laboratory Medicine (Dr. Okabe), Shinshu University School of Medicine, Matsumoto, Japan.

Correspondence to: Yoshitaka Yamazaki, MD, PhD, Department of Endoscopy, Shinshu University School of Medicine, Asahi, Matsumoto, 390-8621, Japan.

Abstract

Background: Bronchoscopic microsampling (BMS) is a method in which a device consisting of a wire with a polyester probe at the tip is used to collect bronchial epithelial lining fluid with bronchoscopy. In this study, we bacteriologically investigated sample collection using BMS to incorporate BMS into diagnosis of respiratory infection.

Methods: Strains of Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Mycobacterium avium complex (MAC), were used for experiments. In the standard sampling procedure using BMS, the probe coming out of the sheath was immersed in approximately 6 x 10⁶ cfu/mL bacterial suspension for 30 s and cut into a tube containing 1 mL of normal saline solution. The tube was stirred for 1 min using a vortex. The sampling rate was calculated by the following equation: (actual amount of bacteria collected by BMS [colony forming units per milliliter])/(bacterial amount in suspension for sampling [colony forming units per milliliter]) x 100 (percentage).

Results: The sampling rate of S pneumoniae, H influenzae, and MAC showed no significant difference among three bacteria, but the sampling rate of P aeruginosa was higher. The shortened time of sampling, stirring, and the reduced bacterial amount in the suspension (1/100) did not significantly affect the rates of standard procedure. In contrast, in comparison with a protected specimen brush (PSB), the recoveries of S pneumoniae, H influenzae, and MAC using PSB were significantly lower than those by BMS, but the recovery of P aeruginosa was not significantly different.

Conclusion: This in vitro study might suggested the usefulness of BMS as a new diagnostic technique capable of quantitative and stable sampling.

Key Words: BAL • bronchial epithelial lining fluid • bronchoscopic microsampling • protected specimen brush

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