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BAL fluid analysis in the identification of infectious agents in patients with hematological malignancies and pulmonary infiltrates
P. Zak, E. Vejrazkova, A. Zavrelova, L. Pliskova, L. Ryskova, P. Hubacek, V. Stepanova, M. Kostal, V. Koblizek, P. Paterova, J. Radocha,
Language English Country United States
Document type Journal Article
Grant support
PROGRES Q40/08
PROGRES Q40/08
grant no. 17-28539A
grant no. 17-28539A
MH CZ - DRO (UHHK, 00179906)
MH CZ - DRO (UHHK, 00179906)
NV17-28539A
MZ0
CEP Register
- MeSH
- Aspergillus genetics isolation & purification pathogenicity MeSH
- Bronchoalveolar Lavage Fluid microbiology MeSH
- DNA, Fungal genetics MeSH
- Adult MeSH
- Hematologic Neoplasms complications microbiology MeSH
- Intensive Care Units MeSH
- Middle Aged MeSH
- Humans MeSH
- Mannans analysis MeSH
- Adolescent MeSH
- Young Adult MeSH
- Neutropenia microbiology MeSH
- Pneumocystis carinii genetics isolation & purification pathogenicity MeSH
- Pneumonia, Pneumocystis diagnosis microbiology MeSH
- Retrospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Streptococcus pneumoniae genetics isolation & purification pathogenicity MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
The present study aims to evaluate the diagnostic yield of bronchoalveolar lavage (BAL) fluid in patients with hematological malignancies and describe the most common pathogens detected in BAL fluid (BALF.) An analysis of 480 BALF samples was performed in patients with hematological malignancies over a period of 7 years. The results of culture methods, PCR, and immunoenzymatic sandwich microplate assays for Aspergillus galactomannan (GM) in BALF were analyzed. Further, the diagnostic thresholds for Aspergillus GM and Pneumocystis jiroveci were also calculated. Microbiological findings were present in 87% of BALF samples. Possible infectious pathogens were detected in 55% of cases; 32% were classified as colonizing. No significant difference in diagnostic yield or pathogen spectrum was found between non-neutropenic and neutropenic patients. There was one significant difference in BALF findings among intensive care units (ICU) versus non-ICU patients for Aspergillus spp. (22% versus 9%, p = 0.03). The most common pathogens were Aspergillus spp. (n = 86, 33% of BAL with causative pathogens) and Streptococcus pneumoniae (n = 46, 18%); polymicrobial etiology was documented in 20% of cases. A quantitative PCR value of > 1860 cp/mL for Pneumocystis jirovecii was set as a diagnostic threshold for pneumocystis pneumonia. The absorbance index of GM in BALF of 0.5 was set as a diagnostic threshold for aspergillosis. The examination of BAL fluid revealed the presence of pathogen in more than 50% of cases and is, therefore, highly useful in this regard when concerning pulmonary infiltrates.
References provided by Crossref.org
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