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Related Experiment Videos

Should fiberoptic bronchoscopy aspirates be cultured?

J G Bartlett, J Alexander, J Mayhew

    The American Review of Respiratory Disease
    |July 1, 1976
    PubMed
    Summary

    Fiberoptic bronchoscopy may not reliably detect lower respiratory tract bacteria due to contamination from the upper airways and anesthetic effects. This study highlights potential inaccuracies in bacteriology assessments using this method.

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    Area of Science:

    • Pulmonology
    • Microbiology
    • Medical Procedures

    Background:

    • Fiberoptic bronchoscopy is a common tool for diagnosing lower respiratory tract infections.
    • Accurate bacteriological analysis is crucial for effective antibiotic treatment.

    Purpose of the Study:

    • To evaluate the reliability of fiberoptic bronchoscopy for lower respiratory tract bacteriology.
    • To identify potential sources of contamination and confounding factors during the procedure.

    Main Methods:

    • Suction aspiration via fiberoptic bronchoscope after lidocaine anesthesia.
    • Culture of aspirates to detect oropharyngeal bacteria.
    • Comparison with transtracheal aspiration cultures.
    • Assessment of anesthetic solution volume in specimens.

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  • Evaluation of lidocaine's effect on bacterial pathogens.

    • Main Results:

    • All methods indicated oropharyngeal bacterial contamination introduced during instrumentation.
    • Up to 96% of specimens consisted of anesthetic solution.
    • Lidocaine demonstrated toxicity to various lower respiratory tract pathogens, with species-specific differences.

    Conclusions:

    • Fiberoptic bronchoscopy, as performed in this study, is unreliable for assessing lower respiratory tract bacteriology.
    • Oropharyngeal contamination and anesthetic effects significantly impact specimen accuracy.
    • Alternative methods or modifications may be needed for reliable respiratory tract sample collection.