Lung Puncture-Aspiration as a Bacteriologic Diagnostic Procedure in Acute Pneumonias of Infants and Children

Abstract

Lung puncture-aspiration is simple and generally innocuous. For the study of acute pneumonia it is superior to examination of nasopharyngeal, throat or laryngeal cultures and gives more positive results than does blood culture. It can be extremely useful in investigational studies and with selected patients in whom identification of the precise pathogen is necessary for optimal antibiotic therapy. ETIOLOGIC diagnosis of lower respiratory tract infections has always been a vexing problem. Commonly employed diagnostic procedures, such as cultures taken from the upper respiratory tract, have little usefulness and clinical and radiologic investigation of the patient seldom indicate the specific etiology. In general, the bacteria recovered from the nasopharynx, throat and sputum are not the same as the true pathogens obtained from pulmonary tissues in cases of acute pneumonia.1-8 Sometimes a blood culture is helpful, but one encounters bacteremia in no more than 30 per cent of pneumococcal pneumonias and iñ ~ per cent or less of those due to streptococcus or staphylococcus. Only in pneumonia due to Hemophilus a~xflue~z~~e does one frequently find positive blood cultures.9-12 For these reasons we decided to use lung puncture-aspiration as a means of obtaining reliable specimens for bacteriologic study in pneumonias of infancy and childhood. HistoryLung puncture-aspiration was first employed by Leyden in 1882. 13 In 1909 Horder 14, 15 recommended its use with any patient having signs of consolidation if the course of illness was unfavorable and with pulmonary abscess and bronchiectasis in order to recover pathogenic bacteria unmixed with the throat flora. He

Worldwide Haemophilus influenzae Type b Disease at the Beginning of the 21st Century: Global Analysis of the Disease Burden 25 Years after the Use of the Polysaccharide Vaccine and a Decade after the Advent of Conjugates

“…Reliable information on the etiology of pneumonia based on lung tap was also obtained for Latin America (52,110,122,142,149); this method is also used in Africa and Oceania (115,152,180). H. influenzae, supposedly often Hib, turned out to be an essential pathogen in all these studies.…”

“…Besides the best-known entity, meningitis, all Hib entities such as epiglottitis, nonfocal septicemia, cellulitis, osteomyelitis, and septic arthritis were identified. Hib pneumonia associated with bacteremia was differentiated from pneumonia without bacteremia because several studies from the developing world (3,115,122,152,180,183; S. P. Lupisan, H. Nohynek, M. R. Z. Capeding, L. T. Sombrero, G. Esparar, E. Herva, B. P. Quiambao, P. E. Abucejo, L. G. Pascual, J. Arcay, V. L. Tallo, P. H. Mäkelä, and P. Ruutu, Abstr. Int.…”

“…Otherwise, the role of H. influenzae is indisputable. For example, H. influenzae was the second leading cause of culture-proven bacterial pneumonia in children in Latin America (52,110,122,142,149).…”

Neumonías por gérmenes Gram negatives

“…***Anatomia Patoldgica, Hospital Sotero del Rfo, 4.-Cultivo de muestra obtenida por puncidn pulmonar. (4,6,7,8,9,10). Este metodo es el mas apropiado, por: a) Obtener la muestra en forma directa del foco comprometido (evitandose el riesgo de los falsos positives); b) T6cnica simple; c) Bajo porcentaje de complicaciones (1-2%).…”

Safety and immunogenicity of an indigenously developedHaemophilus influenzaetype b conjugate vaccine through various phases of clinical trials

“…2 The burden of Hib disease is proved in large studies conducted in Africa, Asia and Latin America where the vaccine was found to be useful in reducing childhood infections. [3][4][5] In view of demonstrated safety and efficacy, World Health Organization (WHO) recommends that conjugate Hib vaccines should be included in all routine infant immunization program. 2 Hib vaccination also reduces nasopharyngeal colonization with the organism, leading to substantial reduction in disease incidence than can be directly attributed to the effects of the vaccine.…”