Keywords
drug-resistant bacteria
bronchial washing
Abstract
THE ANALYSIS OF BACTERIOLOGICAL EXAMINATION OF BRONCHIAL WASHINGS IN PATIENTS WITH RESPIRATORY TRACK DISEASES WITH SPECIAL RESPECT TO OBSTRUCTIVE PULMONARY DISEASES
Introduction. Infections of the lower respiratory airways track are one of the leading causes of morbidity and mortality all around the world. They exert huge influence over both the development and course of pulmonary diseases and also often lead to an exacerbation of obstructive lung diseases.
Aim. The analysis of bacteriological examinations and changes in microbiological profile in bronchial washings.
Material and methods. A retrospective analysis of microbiological examinations of bronchial washings was performed on 1658 patients (777 in 2011 and 881 in 2013). The analysis included 153 COPD and 128 asthmatic patients. Bronchial washings were obtained after instilling isotonic saline in 2011 and Ringer‘s solution in 2013.
Results. Bacteriological examinations of bronchial washing usually revealed a normal bacterial flora (51.87%). In COPD patients, the most often isolated pathogens were Staphylococcus aureus (14.38%) and Pseudomonas aeruginosa (13.73%). In asthmatic patients during exacerbations the most common pathogens were Staphylococcus aureus (15.63%) and Klebsiella pneumoniae (7.81%). The presence of drug-resistant strains was detected in 162 cases (9.77%). The following ones were found most frequently: Staphylococcus aureus MRSA – methicyllin-resistant Staphylococcus aureus, Klebsiella pneumoniae ESBL – extended-spectrum ?-lactamases (+) and Pseudomonas aeruginosa. A statistically significant difference was found in case of Proteus mirabilis, with the incidence rate of 22 cases in 2013 and merely 10 cases in 2011 (2.83% vs 1.14% respectively; p=0.01), which may suggest protective role of NaCl used for collecting of bronchial washing.
Conclusions. Microbiological examinations of bronchial washings make it possible to identify pathogens responsible for infections of the lower respiratory tract.
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