“Clinical Utility of Broncho Alveolar Lavage in Microbial Analysis in Children with Chronic Lung Disease"

Abstract

Clinical Utility of Bronchoalveolar Lavage in Microbial Analysis in Children with Chronic Lung Disease

Objective: To determine whether flexible bronchoscopy and bronchoalveolar lavage (BAL) provide clinically useful information regarding final diagnosis and microbial flora identification in young children with chronic lung disease (CLD) poorly responsive to antibiotic therapy.

Study design: A descriptive cross sectional study.

Place and Duration of Study: The department of Pediatric pulmonology of The Children’s Lahore from January 2018 to December 2018.

Methodology: This study included 70children of both genders between 1-16 years with chronic lung disease and flexible bronchoscopy and BAL done in all patients.

Results: Mean age of children was7.53±3.743years, majority (61.4%) were>6 years of age with slight male predominance (53%).Non-cystic CLD predominated (91.4% )and (9%) were cases of cystic fibrosis(CF). The causes of non-cystic CLD were; suspected tuberculosis (51%) or tuberculosis treatment failure (11%), recurrent pneumonias (19%), idiopathic (10%). Fluid culture for pathogens was positive in (73%). Microbial flora isolated were Pseudomonasin all (100%) of CF patients while in non-cystic CLD it was present in(33%)(p=0.002), Streptococcus pneumoniae (26%), Staph aureus (15%), Klebsiella (11.4%)and Mycobacterium abscesses (3%). Gene expert was positive in (17%), fungus (8.6%) and Acid fast bacilli (AFB) (5.7%). Gene expert was significantly associated with non-cystic CLD (p-0.002), and with recurrent pneumonia, (p=0.012).

 AFP and Gene expert positivity also showed significant association (p=0.021).

Conclusion:

BAL is a useful diagnostic tool for microbial analysis in children with chronic lung diseases and helps in achieving the final diagnosis of CLD.

Keywords: Bronchoscopy, Bronchoalveolar Lavage (BAL), microbial. Chronic lung disease (CLD). Bronchoalveolar Lavage Fluid (BALF).