Bronchial bacterial colonization in patients with resectable lung carcinoma

Abstract

The pattern and clinical implications of bronchial bacterial colonization have been widely investigated in patients with chronic lung disease, particularly chronic obstructive pulmonary disease. The main aim of this study was to determine the frequency and risk factors for bronchial colonization in lung cancer patients who have undergone surgical resection.Forty-one patients with resectable lung cancer (22 (54%) active smokers, 52¡23 pack-yrs) with a mean forced expiratory volume in one second of 80 ¡ 16% predicted, were studied with bilateral protected specimen brush and lung tissue biopsy during the surgical procedure. Quantitative bacterial culture, susceptibility tests and histological examination of samples were performed.Bronchial colonization with o1 potential pathogenic micro-organism was found in 17 of 41 (41%) patients. The most frequent strains isolated were: Haemophilus influenzae (35%), Streptococcus pneumoniae (13%) and Pseudomonas spp. (9%). The risk factors for bronchial colonization were central location of the tumour (odds ratio (OR)=9.2, confidence interval (CI) 95%=2.1-39.6, p=0.003) and increased body mass index (OR=1.6, CI 95%=1.2-2.2, p=0.005). The frequency of postoperative infectious pulmonary complications was low (five cases (12%)) and no relationship was observed with bronchial colonization.Patients with resectable lung carcinoma had a high rate of bronchial colonization (41%), mainly with potential pathogenic microorganisms. The independent risk factors for colonization in these patients were central location of the tumour and a high body mass index.

Bronchial colonisation in patients with lung cancer: a prospective study

“…The incidence and nature of bacterial colonisation were similar to those reported in other large prospective or retrospective studies, which highlight the high frequency of the potentially pathogenic Gram-negative bacilli [2,5,6,11,12]. These bacteria are responsible for the main pulmonary complications observed during the course of bronchial cancers [2,3,8].…”

“…Microorganisms have been isolated from bronchoalveolar fluid, sputum, protected specimen brush and bronchoscopic aspirations. In some cases, colonisation has not been clearly distinguished from infection because of the absence of specific colonisation thresholds: o10 2 cfu?mL -1 for protected specimen brush or o10 4 cfu?mL -1 for bronchial aspirates, irrespective of the species of microorganism [5,11,12]. Moreover, these studies do not discriminate between bronchial samples used for cancer diagnosis and those obtained during neoplastic evolution, except in our retrospective study of 388 patients [11].…”

Microbiome Diversity in the Bronchial Tracts of Patients with Chronic Obstructive Pulmonary Disease

“…The use of molecular methods such as PCR amplification of the 16S rRNA gene, followed by cloning and traditional Sanger sequencing in bronchial secretion samples, has allowed the identification of bacterial species previously undetected by the selective cultures used for the identification of PPM and, more recently, the application of pyrosequencing to PCRamplified products from human samples has taken the study of microbial diversity to an unprecedented level of detail (7,14,17). These approaches have shown that there is a wide diversity of microorganisms in respiratory secretions that remain undetected in culture (15) and have suggested that the bronchial microbiome may be heterogeneous in COPD, with significant differences between bronchial sections (14), a finding previously reported in protected specimen brush samples from patients with respiratory disease (20) and not observed in healthy subjects (7). Accordingly, before the initiation of large studies focusing on the microbiome of the bronchial tree in well-characterized COPD patients, it is necessary to examine the microbial diversity across its different sections, so that the interpretation of the results obtained through sampling of the different bronchial tree compartments is accurate.…”

Respiratory infections after lung cancer resection

“…The authors suggest that the prophylaxis schedule administered in the perioperative period would not strictly be applicable to respiratory infections after a lung resection. In our experience [33,34] 40% of patients with a bronchogenic carcinoma already have their distal airway colonized by pathogenic microorganisms at the time of the operation; postoperative lung infections are significantly more frequent in those patients who have their airway colonized in this way and concordance between the pathogens that colonized the airway and the causes of the postoperative respiratory infections is 51%.…”