Pathogenic characteristics of sputum and bronchoalveolar lavage fluid samples from patients with lower respiratory tract infection in a large teaching hospital in China: a retrospective study

Abstract

Background Lower respiratory tract infection (LRIs) is very common both in terms of community-acquired infection and hospital-acquired infection. Sputum and bronchoalveolar lavage fluid (BALF) are the most important specimens obtained from patients with LRI. The choice of antibiotic with which to treat LRI usually depends on the antimicrobial sensitivity of bacteria isolated from sputum and BALF. However, differences in the antimicrobial sensitivity of pathogens isolated from sputum and BALF have not been evaluated. Methods A retrospective study was conducted to analyze the differences between sputum and BALF samples in terms of pathogen isolation and antimicrobial sensitivity in hospitalized patients with LRI. Results Between 2013 and 2015, quality evaluation of sputum samples was not conducted before performing sputum culture; however, between 2016 and 2018, quality evaluation of sputum samples was conducted first, and only quality-assured samples were cultured. The numbers of sputum and BALF in 2013–2015 were 15,549 and 1671, while those in 2016–2018 were 12,055 and 3735, respectively. The results of pathogen culture showed that Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Hemophilus influenzae, Escherichia coli, Stenotrophomonas maltophilia , and Streptococcus pneumoniae were in the top ten pathogens isolated from sputum and BALF. An antimicrobial susceptibility test showed that the susceptibility of BALF isolates to most antibiotics was higher compared with the susceptibility of sputum isolates, especially after quality control of sputum samples (2016–2018). Conclusions Our findings suggest that caution is needed in making therapeutic choices for patients with LRI when using antimicrobial sensitivity results from sputum isolates as opposed to BALF isolates.

Alterations of the Human Lung and Gut Microbiomes in Non-Small Cell Lung Carcinomas and Distant Metastasis

“…We found that 16 genera were depleted in sputum samples of the NSCLC group ( Fig. 3A ); both Neisseria and Fusobacterium were the dominant genera in the lung microbiota ( 13 ). These results confirmed that the sputum microbiome had been significantly altered in patients.…”

“…Huang et al compared the microbiotas of the lung (bronchoalveolar fluid) and sputum in LC patients and found similarly dominant taxonomic entities (taxa) at both phylum (such as Firmicutes , Bacteroidetes , Proteobacteria , Actinobacteria , and Fusobacteria ) and genus (such as Streptococcus , Prevotella , Neisseria , Porphyromonas , Veillonella , and Haemophilus ) levels, although some taxa might show significantly different abundances between the two microbiotas ( 12 ). In addition, Zheng et al compared the pathogens isolated from lung (bronchoalveolar fluid) and sputum and found that the top 10 most abundant ones were identical in both types of samples ( 13 ). Together, these studies suggest that sputum could be used as a close proxy for the lung.…”

Value of sputum Gram stain, sputum culture, and bronchoalveolar lavage fluid Gram stain in predicting single bacterial pathogen among children with community-acquired pneumonia

“…Though they are also used for pathogen detection, their value in detecting causative pathogen is also unclear. A simple comparison of sputum culture and BALF culture was made in some studies, but the agreement between these two methods was seldom analyzed [ 10 , 11 ]. Few studies assessing the diagnostic accuracy of BGS used BALF culture as the reference standard.…”

The performance of detecting Mycobacterium tuberculosis complex in lung biopsy tissue by metagenomic next-generation sequencing

“…Infectious diseases remain the leading cause of morbidity and mortality around the world [ 1 ].The lung infection, the most common infectious disease, has attracted wide concern, especially when it occurs in the form of explosive emerging infectious diseases such as severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) [ 2 , 3 ]. However, some specific pulmonary infectious diseases should not be ignored.…”