Mini BAL vs Bronchoscopic BAL in Intubated Patients in a Tertiary Care Centre, Mahabubnagar, AP: Our Experience

Abstract

Background: Isolation of organisms in intubated patients has posed a lot of problems.Invasive procedure has been used to obtain respiratory samples for culture. The invasive procedures like bronchoalveolar lavage (bronchoscopic guided or blind), tracheal aspirate, bronchial brushings are being used. Objective: To find the efficacy of isolation of organisms using MINIBAL when compared with bronchoscopic BAL in intubated patients. Materials and methods: Intubated patients with consolidation were included in the study. Results:The observation was made in totally in 60 patients. In 30 patients bronchoscopic BAL was done and the other 30 patients MINIBAL was done. Organisms were isolated in 24 patients in whom MINIBAL was done and in 26 patients in whom bronchoscopic BAL was done. Conclusion:In patients who are intubated BAL is playing pivotal role in isolating organisms.Bronchoscopic BAL is a costly procedure. MINIBAL is an easy procedure, which is cost effective and sufficiently effective in isolating organisms.

Detection of Bacteria Causes Ventilator Associated Pneumonia with Bronchoalveolar Lavage Culture and Endotracheal Aspirate Culture

“…Antibiotic sensitivity profile of bacteria isolated from bronchoalveolar lavage culture using bronchoscopy fiber flexural optics and from endotracheal aspirate culture using catheter hose.PAGE 44Indonesian Journal of Clinical Pathology and Medical Laboratory, 2019 Nov, 26(1) :40 -45 Empirical antibiotic therapy for early-onset V A P i s b e t a -l a c t a m / a n t i -b e t a -l a c t a m a s e (amoxicillin-clavulanate), third-generation antipseudomonal cephalosporins (ceftriaxone, cefotaxime) or quinolone (levofloxacin). Whereas empirical antibiotic therapy for late-onset VAP is antipseudomonal cephalosporin (cefepime, ceftazidime), antipseudomonal carbapenem (meropenem, imipenem) or beta-lactam/anti b e t a -l a c t a m a s e ( p i p e r a c i l l i n -t a z o b a c t a m ) , s u p p l e m e n t i o n w i t h a n t i p s e u d o m o n a l fluoroquinolone (ciprofloxacine or levofloxacine) or aminoglycosides (amikacine, gentamicine or tobramicine), supplemention with Linezolide or 9 vancomicine (if suspected of MRSA).…”