In Brief | Comparative study of diagnostic efficacy of sputum and bronchoalveolar lavage fluid specimens in community-acquired pneumonia children treated with fiberoptic bronchoscopy

Originally published In BMC Infectious Diseases: 29 August 2023
 

Community-acquired pneumonia (CAP) poses a significant threat to childhood health worldwide, emphasizing the importance of selecting the right respiratory specimen for diagnosis. Traditionally, sputum and upper respiratory secretions like nasal and pharyngeal swabs have been used, but contamination from upper respiratory pathogens has been a concern.
 

Fiberoptic bronchoscopy (FOB) with bronchoalveolar lavage (BAL) has emerged as a valuable diagnostic tool for pneumonia, known for its lower susceptibility to oral microorganism contamination. However, a comprehensive comparison between induced sputum (IS) and bronchoalveolar lavage fluid (BALF) for pathogen detection has been lacking.
 

This study examined 142 hospitalized children undergoing bronchoalveolar lavage, analysing paired sputum and BALF samples via multiplex PCR to detect nine viruses and two atypical bacteria. This approach allowed for a more thorough assessment of the molecular results obtained from different respiratory specimens for multiple pathogens.

The following findings were recorded:

• An overall positivity rate of 85.9% for sputum and 80.3% for BALF, with a high agreement for detecting certain pathogens such as M. pneumoniae, influenza A, influenza B, bocavirus, and RSV. 

• Adenovirus exhibited a low agreement level and a high false-negative rate, while rhinovirus had a significant false-positive rate.

• In 59.9% of cases, multiplex PCR results were consistent, with single detections being more common than mixed detection.
 

These results suggest that the consistency of results between sputum and BALF varies by pathogen, emphasizing the need for caution when considering sputum as a substitute for BALF, especially in young children or when co-infections with bacteria are suspected.

Access the original article 

Wang, L., Lu, S., Guo, Y. et al. Comparative study of diagnostic efficacy of sputum and bronchoalveolar lavage fluid specimens in community-acquired pneumonia children treated with fiberoptic bronchoscopy. BMC Infect Dis 23, 565 (2023). https://doi.org/10.1186/s12879-023-08522-3

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