Usefulness of bronchial sputum aspirate specimens for the diagnosis of Non-tuberculous mycobacterial pulmonary disease

IF 2.4 Q2 RESPIRATORY SYSTEM

Respiratory investigation Pub Date : 2025-01-01 DOI:10.1016/j.resinv.2024.12.015

Naohisa Urabe, Susumu Sakamoto, Nozomi Tokita, Keiya Watanabe, Kohshi Fukuda, Kensei Hata, Makiko Takeichi, Shotaro Inokuchi, Kazuma Kishi

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Abstract

Background

The usefulness of bronchoscopy for the diagnosis of NTM pulmonary disease (NTM-PD) has been reported. However, performing bronchoscopy for aspirated sputum and airway secretion specimens (sputum aspirate specimens) in the region extending from the trachea down to the orifice of each segmental bronchus has been poorly documented. We evaluated the diagnostic yield of sputum aspirate specimens collected from the central airway using bronchoscopy.

Methods

We reviewed the medical records of 114 patients with clinically suspected NTM-PD on chest computed tomography (CT) who underwent bronchoscopy. Patients for whom sputum aspirate and bronchial washing specimens were obtained using a thin bronchoscope were included. Positive culture acid-fast bacilli yield was compared between sputum aspirate specimens obtained during bronchial luminal examination and bronchial washing specimens obtained by wedging the tip of the bronchoscope into bronchi with the most affected lung segment.

Results

Among the 69 NTM culture-positive patients, culture positivity yield for sputum aspirate and bronchial washing specimens was 94.2% (65/69) and 88.4% (61/69), respectively. While 8 (11.6%) patients were culture-positive for only sputum aspirate specimens, 4 (5.8%) patients were culture-positive for only bronchial washing specimens. Comparison of chest CT findings and bronchoscopy procedure showed no difference between patients with positive cultures from both sputum aspirate and bronchial washing specimens and those with positive cultures on only one of either specimen.

Conclusions

In diagnosing NTM-PD using thin bronchoscopy, the diagnostic yield of sputum aspirate specimens from the central airway was comparable to that of bronchial washing specimens obtained from the peripheral airway.

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支气管吸痰标本对非结核性分枝杆菌肺病的诊断价值。

背景：支气管镜检查在NTM肺疾病（NTM- pd）诊断中的应用已有报道。然而，对从气管向下延伸至每个支气管节段孔口的区域的吸痰和气道分泌物标本（吸痰标本）进行支气管镜检查的文献很少。我们评估了使用支气管镜从中央气道收集的吸痰标本的诊断率。方法：回顾性分析114例经支气管镜检查的胸部CT疑似NTM-PD患者的病历。包括使用薄支气管镜获得吸痰和支气管洗涤标本的患者。比较支气管腔检查吸痰标本与将支气管镜尖端楔入受影响最严重的肺段支气管洗涤标本培养抗酸杆菌阳性率。结果：69例NTM培养阳性患者中，吸痰标本和支气管洗涤标本培养阳性率分别为94.2%（65/69）和88.4%（61/69）。仅痰液标本培养阳性8例（11.6%），仅支气管洗涤标本培养阳性4例（5.8%）。胸部CT表现和支气管镜检查结果的比较显示，吸痰和支气管洗涤标本培养均阳性的患者与仅其中一种标本培养阳性的患者之间没有差异。结论：薄支气管镜诊断NTM-PD时，中央气道吸痰标本的诊断率与周围气道支气管洗涤标本的诊断率相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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