Bacteriology of Lower-Respiratorytract Secretions, Sputum, and Upper-Respiratory-Tract Secretions in " Normals " and Chronic Bronchitics

Lees, A.W.; McNaught, William

doi:10.1016/s0140-6736(59)90099-6

Cited by 133 publications

(25 citation statements)

References 11 publications

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“…Distal airways are usually sterile in healthy nonsmoking individuals as has been demonstrated in various studies [1,2]. However, when mechanical airway defences are altered, as occurs in chronic bronchitis, chronic obstructive pulmonary disease (COPD), bronchiectasis or bronchial obstruction, or there is a bypass of oropharyngeal defences, e.g.…”

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confidence: 99%

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Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

Cabello

Torres²,

Celis³

et al. 1997

Eur Respir J

262

216

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In contrast to the healthy population, distal airway bacterial colonization may occur in patients with chronic lung diseases, who often have altered pulmonary defences. However, the information dealing with this issue is insufficient and is based mainly on nonspecific samples, such as sputum cultures.Using quantitative cultures of bronchoscopic protected specimen brush (PSB) and bronchoalveolar lavage (BAL) samples, we studied the bacterial colonization of distal airways in 16 healthy subjects, 33 patients with bronchogenic carcinoma, 18 with chronic obstructive pulmonary disease (COPD), 17 with bronchiectasis, and 32 with a long-term tracheostomy due to laryngeal carcinoma. All patients were without exacerbation, and free from antibiotic treatment at least 1 month before the study protocol. Thresholds for quantitative cultures to define colonization were ≥10 2 colony-forming units (cfu)·mL -1 for PSB and ≥10 3 cfu·mL -1 for BAL.Only one healthy subject was colonized by a potential pathogenic microorganism (PPM) (Staphylococcus aureus 4×10 2 cfu·mL -1 in a PSB culture). Colonization was observed in 14 (42%) bronchogenic carcinoma patients (19 non-PPMs, and 10 PPMs); in 15 (83%) COPD patients (22 non-PPMs and 7 PPMs); in 15 (88%) bronchiectasis patients (20 non-PPMs and 13 PPMs); and in 15 (47%) long-term tracheostomy patients (5 non-PPMs and 13 PPMs). The two most frequent nonPPMs isolated in all groups studied were Streptococcus viridans and Neisseria spp. Haemophilus spp., Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were the most frequent PPMs isolated in bronchogenic carcinoma, COPD, bronchiectasis and long-term tracheostomized patients, respectively. Pseudomonas aeruginosa colonization was infrequent in all the groups.Our results show that distal airway bacterial colonization is a frequent feature in stable patients with chronic lung diseases and also in patients with long-term tracheostomy. However, the pattern of colonization differs among groups studied. The knowledge of different colonization patterns may be important for future antibiotic prophylactic strategies and for the empirical antibiotic regimens when exacerbations occur in these patients.

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confidence: 99%

“…Several studies have demonstrated frequent airway colonization in stable COPD and bronchiectatic patients [1,3,4,11,12]. The information regarding distal airway colonization in tracheostomized patients or those with bronchogenic carcinoma is scarce.…”

mentioning

confidence: 99%

Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

Cabello

Torres²,

Celis³

et al. 1997

Eur Respir J

262

216

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“…Recent bacteriologic studies have shown that the bronchial secretions of human beings are usually sterile in the absence of evident bronchopulmonary disease (1)(2)(3). However, bacterial contamination of the bronchi by inspired air, and perhaps by upper respiratory tract secretions, can be considered to be a common occurrence.…”

mentioning

confidence: 99%

A Quantitative Study of the Deposition and Clearance of Bacteria in the Murine Lung*

Laurenzi¹,

Berman²,

First³

et al. 1964

J. Clin. Invest.

104

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“…Present incidence of pulmonary infection with gram-negative bacilli and other unusual pathogens is on a rise and because expectorated sputum is contaminated by mouth flora, it is not always a reliable indicator of the organisms present in the lower respiratory tract. [1][2][3][4][5] Furthermore, in some cases the flora of the upper tract secretions may falsely indicate a pulmonary pathogen or may overgrow the actual pathogen. Attempts have been made to avoid the problem of contamination by the oropharyngeal secretions by sampling the lower respiratory tract through a bronchoscope, trans-tracheal aspiration, and transthoracic lung aspiration.…”

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confidence: 99%

Diagnostic usefulness of transtracheal aspiration in lower respiratory tract infections

et al. 2017

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Background: The incidence of pulmonary infections is on a constant rise. The present study was undertaken in order to identify those patients in whom transtracheal aspiration is most likely to provide information not obtainable from evaluation of expectorated sputum and delineates the clinical conditions under which transtracheal aspiration is indicated.Methods: A total of 50 patients of lower respiratory tract infections were studied. Both sputum and trans-tracheal aspirate samples were compared by Gram’s stain and culture methods.Results: Gram’s staining of the sputum was non-helpful in most cases as it showed mixed organisms while trans-tracheal aspiration showed only single type of colony. Culture showed less growth in sputum samples as compared to trans-tracheal aspirates.Conclusions: Trans-tracheal aspirate appears to be a very good method for isolating infective agents in lower respiratory tract infections. Besides by passing the contaminants of the oropharynx, it pinpoints the organism in most cases.

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Bacteriology of Lower-Respiratorytract Secretions, Sputum, and Upper-Respiratory-Tract Secretions in " Normals " and Chronic Bronchitics

Cited by 133 publications

References 11 publications

Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

Bacterial colonization of distal airways in healthy subjects and chronic lung disease: a bronchoscopic study

A Quantitative Study of the Deposition and Clearance of Bacteria in the Murine Lung*

Diagnostic usefulness of transtracheal aspiration in lower respiratory tract infections

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