摘要：OBJECTIVE:To assess the increased diagnostic yield for pulmonarytuberculosis using bronchial washing cultures compared with sputum cultures.METHODS:Study conducted with 61 adults in Lima, Peru, from January 2006to December 2007. The yield of sputum cultures was compared with the yieldof acid-fast bacilli smears and cultures of bronchial washing for diagnosingpulmonary tuberculosis in suspected cases of clinical tuberculosis with negativeacid fast bacilli sputum smears.RESULTS:Twenty seven (95%CI 32;58) of the cases were eventually diagnosedwith smear-negative pulmonary tuberculosis. Bronchial washing samplesdetected 23 (95%CI 72;99) of the smear-negative pulmonary tuberculosiscases compared with 15 (95%CI 37;74) for sputum cultures (p = 0.02). Theincremental diagnostic yield of acid fast bacilli smear and culture of bronchialwashing specimens over sputum culture was 44% (95%CI 25;65).CONCLUSIONS:In function of the epidemiological context and the resourcesavailable, bronchoscopy should be deployed as part of a comprehensive work upthat optimizes smear-negative pulmonary tuberculosis diagnosis and minimizesrisk and costs.
其他摘要：OBJECTIVE:To assess the increased diagnostic yield for pulmonarytuberculosis using bronchial washing cultures compared with sputum cultures.METHODS:Study conducted with 61 adults in Lima, Peru, from January 2006to December 2007. The yield of sputum cultures was compared with the yieldof acid-fast bacilli smears and cultures of bronchial washing for diagnosingpulmonary tuberculosis in suspected cases of clinical tuberculosis with negativeacid fast bacilli sputum smears.RESULTS:Twenty seven (95%CI 32;58) of the cases were eventually diagnosedwith smear-negative pulmonary tuberculosis. Bronchial washing samplesdetected 23 (95%CI 72;99) of the smear-negative pulmonary tuberculosiscases compared with 15 (95%CI 37;74) for sputum cultures (p = 0.02). Theincremental diagnostic yield of acid fast bacilli smear and culture of bronchialwashing specimens over sputum culture was 44% (95%CI 25;65).CONCLUSIONS:In function of the epidemiological context and the resourcesavailable, bronchoscopy should be deployed as part of a comprehensive work upthat optimizes smear-negative pulmonary tuberculosis diagnosis and minimizesrisk and costs.
关键词：Bronchoalveolar Lavage; Tuberculosis; diagnosis; Diagnostic Techniques and Procedures; Sensitivity and Specificity.
其他关键词：Bronchoalveolar Lavage; Tuberculosis; diagnosis; Diagnostic Techniques and Procedures; Sensitivity and Specificity.
