title: Comparison of bronchoalveolar lavage and mini-bronchoalveolar lavage in the diagnosis of pneumonia in immunocompromised patients.
abstract: BACKGROUND
  Pneumonia is a major cause of morbidity and mortality in immunocompromised patients. Bronchoalveolar lavage (BAL) is commonly used to help diagnose and characterize pneumonia in these patients. Mini-BAL is a less-invasive, less-costly and less-cumbersome diagnostic tool than BAL.
  
  
  OBJECTIVE
  In this study, we compared the diagnostic value of BAL and mini-BAL in the evaluation of pneumonia in immunocompromised patients with respiratory failure.
  
  
  METHODS
  Sixty-four respiratory samples were collected from 32 immunocompromised patients admitted to our respiratory intensive care unit with a clinical diagnosis of pneumonia and respiratory failure requiring invasive mechanical ventilation. A single BAL sample and a single mini-BAL sample were collected from each patient. Samples were examined for bacteriologic, mycologic, mycobacteriologic, and viral organisms.
  
  
  RESULTS
  The mean age of the patients was 56.0 ± 14.4 years. Of the 32 BAL samples, bacterial isolates were detected in 11 patients (34.4%) and on the other hand bacterial isolates were detected in 10 patients (31.3%) of the mini-BAL samples. Fungal isolates were detected in 11 patients (34.4%) from BAL samples and 13 patients (40.6%) from mini-BAL samples. Our analysis demonstrated a strong positive correlation between the results of BAL and mini-BAL testing (r = 0.850 and r = 0.821, respectively).
  
  
  CONCLUSIONS
  In this study, we demonstrated a strong correlation between the isolation rates of bacteria and fungi in BAL and mini-BAL samples obtained from immunocompromised patients with pneumonia and respiratory failure. The data strongly support the use of mini-BAL sampling in such patients as a less-invasive, less-costly and simpler alternative to traditional BAL.
authors.affiliation: Department of Chest Diseases, Ege University School of Medicine, Izmir, Turkey. sezai72000@yahoo.com
authors.forename: M Sezai
authors.initials: MS
authors.lastname: Tasbakan
authors.forename: Alev
authors.initials: A
authors.lastname: Gurgun
authors.forename: Ozen K
authors.initials: OK
authors.lastname: Basoglu
authors.forename: Pervin K
authors.initials: PK
authors.lastname: Ekren
authors.forename: Husnu
authors.initials: H
authors.lastname: Pullukcu
authors.forename: Feza
authors.initials: F
authors.lastname: Bacakoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018893:Bronchoalveolar Lavage / Q000379:methods*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000401:mortality; D011446:Prospective Studies; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D055815:Young Adult