The Value of Routinely Culturing for Tuberculosis During Bronchoscopies in an Intermediate Tuberculosis-Burden Country

Kim, Myung Hoon; Suh, Gee Young; Chung, Man Pyo; Kim, Hojoong; Kwon, O Jung; Lee, Jang Ho; Lee, Nam Yong; Koh, Won‐Jung

doi:10.3349/ymj.2007.48.6.969

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…Bronchoscopy with bronchial washing was performed according to the standard technique as described previously [12,13]. Patients were sedated with intravenous midazolam.…”

Section: Methodsmentioning

confidence: 99%

Additional role of second washing specimen obtained during single bronchoscopy session in diagnosis of pulmonary tuberculosis

et al. 2013

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BackgroundFlexible bronchoscopy with bronchial washing is a useful procedure for diagnosis of pulmonary tuberculosis (TB), when a patient cannot produce sputum spontaneously or when sputum smears are negative. However, the benefit of gaining serial bronchial washing specimens for diagnosis of TB has not yet been studied. Therefore, we conducted a retrospective study to determine the diagnostic utility of additional bronchial washing specimens for the diagnosis of pulmonary TB in suspected patients.MethodsA retrospective analysis was performed on 174 patients [sputum smear-negative, n = 95 (55%); lack of sputum specimen, n = 79 (45%)] who received flexible bronchoscopy with two bronchial washing specimens with microbiological confirmation of pulmonary TB in Samsung Medical Center, between January, 2010 and December, 2011.ResultsPulmonary TB was diagnosed by first bronchial washing specimen in 141 patients (81%) out of 174 enrolled patients, and an additional bronchial washing specimen established diagnosis exclusively in 22 (13%) patients. Smear for acid-fast bacilli (AFB) was positive in 46 patients (26%) for the first bronchial washing specimen. Thirteen patients (7%) were positive only on smear of an additional bronchial washing specimen. Combined smear positivity of the first and second bronchial washing specimens was significantly higher compared to first bronchial washing specimen alone [Total cases: 59 (34%) vs. 46 (26%), p < 0.001; cases for smear negative sputum: 25 (26%) vs. 18 (19%), p = 0.016; cases for poor expectoration: 34 (43%) vs. 28 (35%), p = 0.031]. The diagnostic yield determined by culture was also significantly higher in combination of the first and second bronchial washing specimens compared to the first bronchial washing. [Total cases: 163 (94%) vs. 141 (81%), p < 0.001; cases for smear negative sputum: 86 (91%) vs. 73 (77%), p < 0.001; cases for poor expectoration: 77 (98%) vs. 68 (86%), p = 0.004].ConclusionsObtaining an additional bronchial washing specimen could be a beneficial and considerable option for diagnosis of TB in patients with smear-negative sputum or who cannot produce sputum samples.

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“…Bronchoscopy with bronchial washing was performed according to the standard technique as described previously [12,13]. Patients were sedated with intravenous midazolam.…”

Section: Methodsmentioning

confidence: 99%

Additional role of second washing specimen obtained during single bronchoscopy session in diagnosis of pulmonary tuberculosis

et al. 2013

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“…Bronchoscopy with bronchial washing was performed using the standard technique [6] [7]. Patients were sedated with intravenous midazolam.…”

Section: Bronchoscopy Proceduresmentioning

confidence: 99%

Bronchial Washing to Diagnose Smear-Negative Pulmonary Tuberculosis

Lee¹

2019

JTR

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Introduction: Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative. However, its indication has not been standardized. Therefore, we conducted a retrospective study to assess the diagnostic value of bronchial washing in patients suspected with pulmonary TB. Methodology: A retrospective analysis was performed on patients diagnosed with pulmonary TB in Kosin university gospel hospital, a tertiary hospital with 969 beds in South Korea, from March 2017 to December 2018. We obtained three serial sputum samples for acid-fast bacilli (AFB) smear and culture, and all patients underwent bronchoscopy with bronchial washing for AFB smear and culture. Results: Fifty-six patients were enrolled in the study. Smear-negative pulmonary TB (SNPT) was diagnosed in 42/56 (75%) patients. Among the patients with smear-positive sputum, 14/14 (100%) showed culture-positive sputum, while smear-and culture-positive bronchial washing were seen in 7/14 (50%) and 12/14 (85.7%) patients, respectively. Among the patients with SNPT, 17/42 (40.47%) had culture-negative sputum and were diagnosed using the bronchoscopic washing. Conclusions: For patients with smear-negative sputum, it is necessary to perform bronchoscopic washing to increase the diagnostic rate of pulmonary TB. To control the transmission of pulmonary TB, it is necessary to use a fast and accurate examination method.

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“…However, in some patients, pulmonary tuberculosis is diagnosed from bronchoscopy samples when the patient was not initially thought to be suffering from tuberculosis. 2 Previous studies reported that healthcare workers in the Republic of Korea, which is an intermediate tuberculosis prevalence region (59/100 000 persons per year, 2019), have at least a 4-6% chance of inadvertent exposure to Mycobacterium tuberculosis during conventional bronchoscopy [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe endobronchial ultrasound

et al. 2021

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Background Bronchoscopy using radial probe endobronchial ultrasound (EBUS) is performed when a peripheral lung lesion (PLL) is suspected to be malignant. However, pulmonary tuberculosis is diagnosed in some patients, and healthcare workers could therefore be exposed to tuberculosis if sufficient precautions are not taken. In this study, we examined the proportion of and factors associated with unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS. Methods This retrospective study included 970 patients who received bronchoscopy using radial probe EBUS between December 2015 and November 2018. Clinical, histological, radiological, and microbiological data were reviewed. Results Pulmonary tuberculosis was diagnosed in 31 patients (3.2%) during bronchoscopy using radial probe EBUS. Patients with a lower age were significantly more likely to be diagnosed with tuberculosis than elderly patients (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.924–0.978; P = 0.001). Among the various CT findings, a low HUs difference between pre- and post-enhanced CT (OR, 0.976; 95% CI, 0.955–0.996; P = 0.022), the presence of concentric cavitation (OR, 5.211; 95% CI, 1.447–18.759; P = 0.012), and the presence of satellite centrilobular nodules (OR, 22.925; 95% CI, 10.556–49.785; P < 0.001) were independently associated with diagnosis of tuberculosis. Conclusions The proportion of unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe EBUS was 3.2%. A higher risk was independently associated with a younger age and CT findings of a small difference in HUs between pre- and post-enhancement images, concentric cavitation, and the presence of a satellite centrilobular nodule.

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The Value of Routinely Culturing for Tuberculosis During Bronchoscopies in an Intermediate Tuberculosis-Burden Country

Cited by 6 publications

References 11 publications

Additional role of second washing specimen obtained during single bronchoscopy session in diagnosis of pulmonary tuberculosis

Additional role of second washing specimen obtained during single bronchoscopy session in diagnosis of pulmonary tuberculosis

Bronchial Washing to Diagnose Smear-Negative Pulmonary Tuberculosis

Unexpected exposure to Mycobacterium tuberculosis during bronchoscopy using radial probe endobronchial ultrasound

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