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Microbiologic yield of bronchoalveolar lavage specimens from stem cell transplant recipients
Author(s) -
Sakata Kenneth K.,
Klassen Christine L.,
Bollin Kathryn B.,
Grys Thomas E.,
Slack James L.,
Wesselius Lewis J.,
Vikram Holenarasipur R.
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12684
Subject(s) - medicine , bronchoalveolar lavage , population , pathogen , transplantation , bronchoscopy , surgery , immunology , lung , environmental health
Purpose Stem cell transplant ( SCT ) recipients commonly undergo bronchoalveolar lavage ( BAL ) collection as an infectious pulmonary work‐up. Previous studies report the utility and overall diagnostic yield of fiberoptic bronchoscopy with BAL in this vulnerable population, though none focused purely on microbiologic yield or made comparisons with less invasive means of pathogen detection. We sought to determine and elaborate on the microbiologic yield of BAL in SCT recipients, assess a correlation between BAL studies and less invasive means of pathogen detection, and assess the utility of repeating a BAL within 30 days. Methods Between January 1, 2009, and July 31, 2013, we reviewed medical records of 125 SCT recipients who underwent 179 BAL s. In addition to demographic information and details pertaining to their SCT , a comprehensive review of their microbiologic data was performed and recorded. Results Our study showed an overall BAL microbiologic yield of 40%, despite 92% of patients receiving broad‐spectrum antimicrobial therapy at the time of the BAL procedure. Conclusions Although an initial BAL sample in this population provides crucial microbiologic information, repeating the procedure within 30 days may have minimal additional microbiologic yield. BAL continues to be an essential diagnostic tool in SCT recipients undergoing an infectious pulmonary work‐up.