title: Bronchial colonisation in patients with lung cancer: a prospective study.
abstract: Bronchial colonisation is frequently reported in patients with lung cancer, and has a potential impact on therapeutic management and prognosis. We aimed to prospectively define the prevalence and nature of bronchial colonisation in patients at the time of diagnosing lung cancer. 210 consecutive patients with lung cancer underwent a flexible bronchoscopy for lung cancer. The type and frequency of bacterial, mycobacterial and fungal colonisation were analysed and correlated with the patients' and tumours' characteristics. Potential pathogens were found in 48.1% of samples: mainly the Gram-negative bacilli Escherichia coli (8.1%), Haemophilus influenzae (4.3%) and Enterobacter spp. (2.4%); Gram-positive cocci, Staphylococcus spp. (12.9%) and Streptococcus pneumoniae (3.3%); atypical mycobacteria (2.9%); Candida albicans (42.9%); and Aspergillus fumigatus (6.2%). Aged patients (p=0.02) with chronic obstructive pulmonary disease (p=0.008) were significantly more frequently colonised; however, tumour stage, atelectasis, bronchial stenosis and abnormalities of chest radiography were not associated with a higher rate of colonisation. Squamous cell carcinoma tended to be more frequently colonised than other histological subtypes. Airway colonisation was reported in almost half of patients presenting with lung cancer, mainly in fragile patients, and was significantly associated with worse survival (p=0.005). Analysing colonisation status of patients at the time of diagnosis may help improve the management of lung cancer.
authors.affiliation: Service de Pneumologie, Hôpital Larrey, CHU de Toulouse, Université de Toulouse III (PaulSabatier), Toulouse, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Laroumagne
authors.forename: Benoît
authors.initials: B
authors.lastname: Lepage
authors.forename: Christophe
authors.initials: C
authors.lastname: Hermant
authors.forename: Gavin
authors.initials: G
authors.lastname: Plat
authors.forename: Michael
authors.initials: M
authors.lastname: Phelippeau
authors.forename: Laurence
authors.initials: L
authors.lastname: Bigay-Game
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Lozano
authors.forename: Nicolas
authors.initials: N
authors.lastname: Guibert
authors.forename: Christine
authors.initials: C
authors.lastname: Segonds
authors.forename: Valérie
authors.initials: V
authors.lastname: Mallard
authors.forename: Nathalie
authors.initials: N
authors.lastname: Augustin
authors.forename: Alain
authors.initials: A
authors.lastname: Didier
authors.forename: Julien
authors.initials: J
authors.lastname: Mazieres
mesh_terms: D000368:Aged; D001419:Bacteria / Q000378:metabolism; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis; D001980:Bronchi / Q000382:microbiology*; D001999:Bronchoscopy; D005260:Female; D005658:Fungi / Q000378:metabolism; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009161:Mycobacterium / Q000378:metabolism; D009181:Mycoses / Q000150:complications / Q000175:diagnosis; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome