支气管肺泡灌洗液细菌定量培养对下呼吸道感染的诊断价值

DIAGNOSTIC VALUE OF QUANTITATIVE CULTURES OF BRONCHOALVEOLAR LAVAGE FLUIDS IN PATIENTS WITH LOWER RESPIRATORY TRACT INFECTION

目的：观察不同方法采样培养对下呼吸道感染病原学诊断价值。方法：采用支气管肺泡灌洗液（ＢＡＬＦ０细菌定量培养，并与保护标本刷（ＰＳＢ）和痰培养进行比较。结果：感染组１６例患者２１例次采样，ＢＡＬＦ法１９次阳性（≥１０＾５ｃｆｕ／ｍｌ），ＰＳＢ法１５例次阳性（≥１０＾３ｃｆｕ／ｍｌ），两种方法所获菌株一致率为７２．４％９２１／２９），定量培养结果相关程序较好（ｒ＝０．８０７，Ｐ〈０．００１）。

Objective:The aims of this study were to compare the diagnostic value of cultures of specimens collected by different sampled method of detection the bacterial etiology of lower respiratory tract infection.Method:Quantitative cultures of bronchoalveolar lavage fluids (BALF) were compared with quantitative cultures of protected specimen brush (PSB) and routine sputum cultures.Result:In infected group,16 patients with 21 times were sampled.Quantitative culture of BALF were positive (≥10 5 cfu/ml) in 19 of 21 cases,and that of PSB were positive (≥10 3 cfu/ml) in 15 of 21 cases.The results of BALF cultures in discovering microorganisms were about 72.4%(21/29) in accordance with that of PSB.BALF and PSB quantitative cultures correlated well (r=0.807,P<0.001).The sensitivity of quantiative culture was 85.0% and 95.0% for BALF and PSB respectively,and the specificity was 90.5% ,71.4% respectively.No statistical difference of sensitivity and specificity between BALF and PSB was discovered.There was a low level of agreement (33.3% and 23.6%,respectively) between sputum and BALF,PSB.Conclusion:These results suggest that the diagnostic value of quantitative cultures of BALF and PSB were agreement in patients with lower respiratory infection.The technique is simple and safe.