Citation:Hansamali, D. D. A. A. , Wasana, W. S. , Undugodage, C. , & Dissanayake, D. M. B. T. (2020). Microbiological Analysis of Bronchoalveolar Lavage Fluid of Patients Undergoing Bronchoscopy at Two Tertiary Care Hospitals in Colombo. 3rd Research Symposium of the Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka, 64.
Date:2020-10-02
Abstract:
Background: Microbiological analysis of Bronchoalveolar lavage (BAL) fluid gives valuable
information on pathogens responsible for associated diseases. This study was conducted to
detect a broad group of microorganisms from BAL of patients with different pathologies and to
identify possible associated factors for microbial infection/colonization of lower airways.
Objectives: To describe bacterial and fungal pathogens isolated from BAL to determine the
association of selected factors with lower airway infection/colonization of patients undergoing
bronchoscopy in two tertiary care hospitals in Colombo
Methods: A descriptive cross-sectional study was conducted during a two-month period
including consecutive patients undergoing bronchoscopy. BAL fluid was subjected to
microbiological examination. Association of microbiological findings with selected factors
was determined.
Results: A total of 34 patients with chronic lung disease (9), lung malignancy (14) and
ongoing infections (12) were included. Among 34 BAL samples, 25 (73.5%) samples yielded a
possible/probable pathogen. Aerobic culture yielded bacterial pathogens in 17 (50%) samples.
All were Gram-negative bacteria; Pseudomonas spp. and Klebsiella spp. 8 (44.5%) isolates
each and 2 (11%) Morexella catarrhalis isolates. Antibiotic resistance was relatively low in
these organisms. Fourteen (41.2%) samples were positive for a fungal growth and the
commonest fungal pathogens were Aspergillus spp. (3/14) and Gliocladium spp. (3/14). One
Gram-negative anaerobic bacillus was isolated and one sample was positive for Ziehl-Neelsen
stain. All the patients (100%) with chronic lung disease were infected or colonized with
possible/probable pathogens. Most commonly isolated probable pathogen was Pseudomonas
spp. (88.8%) among patients with chronic lung disease. Half (50%) of diabetic patients and
55.5% of smokers were infected or colonized with possible/probable pathogens.
Conclusions: A high number (73.5%) of BAL revealed growth of possible/probable pathogens
indicating a considerable lower airway colonization/infection rate in this population.
Employing several microbial detection methods enables the recognition of true
colonization/infection rate with microorganisms. The bacteria isolated showed a relatively low
antibiotic resistance. Chronic lung disease is a risk factor for lower airway
colonization/infection.