A new bronchoscopic technique for the diagnosis of bacterial pneumonia in HIV-positive patients.
The aim of the present study was to evaluate in HIV-positive patients with bacterial pneumonia, the diagnostic value of a new endoscopic technique that uses a single catheter to perform a telescopic plugged catheter (TPC) followed by a modified protected bronchoalveolar lavage (mpBAL). Fifty-eight HIV-positive patients with respiratory infection were included in the study. Samples from TPC and mpBAL were cultured quantitatively. Standard bronchoalveolar lavage was performed to rule out opportunistic infections. According to the clinical and microbiological results, patients were classified in the study group (27 with bacterial pneumonia) or the control group (31 without bacterial pneumonia). Sensitivity of TPC was 56% [95% confidence intervals (CI) 37-75%] and its specificity was 100%; these figures were 56% (CI, 37-75%) and 94% (CI, 86-100%) for mpBAL. When both techniques were assessed together, sensitivity increased to 70% (CI, 53-87%). The use of a single catheter reduced the cost of the originally described pBAL procedure by approximately 50%. The use of a single catheter to perform a TPC followed by a mpBAL can improve the diagnostic yield in HIV-positive patients with bacterial pneumonia, and reduces its cost.
Sauleda
J
J
Serveis de Pneumologia, Hospital Universitari Son Dureta, Universitat Illes Balears, Palma de Mallorca, Spain.
Maimó
A
A
Riera
M
M
Ramírez
J
J
Togores
B
B
Pons
S
S
Payeras
A
A
Agusti
A G
AG
D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D008297:Male; D018410:Pneumonia, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D011237:Predictive Value of Tests