Clinical analysis of 165 cases whose bronchoalveolar lavage fluid bacterial culture were positive
LI Haiyan1, YU Lu1, YE Leping1, YANG Jinhong2, DONG Lin1, LI Changchong1.
1.Department of Respiratory, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027; 2.Clinical Bacteriology Laboratory, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027
LI Haiyan,YU Lu,YE Leping, et al. Clinical analysis of 165 cases whose bronchoalveolar lavage fluid bacterial culture were positive[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(11): 830-834,839.
Abstract：Objective: To investigate the clinical characteristics, pathogen spectrum and antibiotic drug sensitive test of patients whose bronchoalveolar lavage fluid culture were positive. To provide the theory basis for clinical diagnosis and treatment for lower respiratory infection in children. Methods: A retrospective review was performed on 1 159 hospitalized cases from January 1, 2013 to December 31, 2015. The information of the patients whose BLAF were sent to lab including clinical data, bacterial culture and drug sensitivity was analyzed. Results: The bacterial culture of BALF in 165 cases were positive, among whom 99(60.0%) were male and 66(40.0%) female. Overall, 70.4% cases were suffered from pneumonia, especially bronchopneumonia. 19 cases (11.5%) were diagnosed as bronchiolitis and combined with bacterial infection. And 12 cases (7.3%) had protracted bacterial bronchitis. One hundred and sixty five organisms from BALF were collected in the survey period, including 112(67.9%) gram-positive bacteria and 53(32.1%) gram-negative bacteria. The five most frequently isolated pathogens were Streptococcus pneumoniae (102 strains), Haemophilus influenza (14 strains), Pseudomonas aeruginosa (13 strains), Escherichia coli (8 strains) and Straphylococcus aureus (8 strains). Sixty five cases (39.4%) had underlying disease and the most common one was deformity of respiratory tract (22 cases) such as malacia, stenosis of trachea or bronchus. There were 14 cases suffered from bronchial asthma. Among 102 Streptococcus pneumoniae strains, there were 25 strains penicillin-sensitive S. pneumoniae, 35 strains penicillin-intermediate S. pneumonia and 42 penicillin-resistant S. pneumonia. Most Staphylococcus aureus strains were methicillin-resistant and there was no vancomycin and linezolid-resistant strain. The drug resistant rates of Haemophilus influenzae to penicillin and the second generation of cephalosporin were high. However, it was sensitive to the third generation of cephalosporin. There were 8 strains of Escherichia coli and five strains produced extended spectrum β-lactamase (ESBL). And 3 of 5 strains of Klebsiella pneumonia were ESBL positive. Conclusion: The most common diagnosis of patients whose bronchoalveolar lavage fluid culture were positive was pneumonia, followed with bronchiolitis which combined with bacterial infection and protracted bacterial bronchitis. The predominant bacteria were Streptococcus pneumonia and Haemophilus influenza.
