Microbiota of Bronchoalveolar Lavage Samples from Patients of Lower Respiratory Tract Infection – A Changing Trend

Abstract

Bronchoalveolar lavage (BAL) is the saline wash of the bronchial tree, which aids in diagnosing various pulmonary pathologies. The present study was contemplated with an aim to know the clinical, microbiological profile of BAL samples along with its sensitivity pattern and to assess its utility as a diagnostic tool. This was a prospective observational study, carried over 90 patients presenting with lower respiratory tract infections. The total microbial recovery rate from BAL was 39 (43.3%). The sensitivity, specificity and positive predictive value of BAL were found to be 76.4%, 89.7% and 90.6% respectively. Maximum isolates were bacteria (25.5%) followed by Mycobacterium tuberculosis (MTB) (16.6%) and fungi (1.1%). Predominant bacterial isolates were Gram-negative (81.5%) compared to Gram-positive (18.5%). Multidrug resistance (MDR) in bacteria was seen in 59.2% of isolates. BAL is a valuable diagnostic tool to find not only bacterial but mycobacterial and fungal infections in patients with lower respiratory tract infection (LRTI). A trend towards LRTI with Gram-negative infections is on the rise and they tend to be multidrug-resistant. Hence checking susceptibility patterns is crucial to start evidence-based treatment.