Analysis On Bacteriological And Mycological In Bronchoalveolar Lavage Samples

Objective: In recent years, lung lavage as a solution to an advanced technology for the diagnosis and treatment of lung diseases, it should be used for pneumoconiosis, alveolar protein deposition disease and other diseases treatment, in addition, the detection of lung lavage lavage fluid after some components can also be used as chronic lung disease(CLD) is an important auxiliary diagnosis. Divided into small volume lung lavage bronchoalveolar lavage and whole lung lavage, which are widely used at present is the whole lung lavage. Whole lung lavage is a kind of general anesthesia with physiological saline lavage technique, many pulmonary diseases are due to bronchial and alveolar excessive axial fluid or purulent secretion retention caused by, and because of the long-term inhalation of harmful dust or abnormal metabolism of deposition in the lung caused by the bubble, such as bronchial pulmonary infection, mucoviscidosis, pneumoconiosis, pulmonary alveolar protein deposition disease, this technology can not only improve the pneumoconiosis patients pulmonary function, eliminate the chest tightness, shortness of breath and other symptoms, the most important thing is to continue to reduce the erosion of dust and curb the disease upgrades, solve any drug can not solve the problem, the two grade prevention function. The bronchoalveolar lavage fluid in addition to clear the lesions and to aid in the diagnosis of infection diseases, especially of pulmonary bacterial and fungal infection early and correct judgment, because specimens source directly on the lesion itself that can represent the progression of the disease. We harvested in the lavage fluid specimens of pulmonary bacterial and fungal infection were analyzed to guide the regional economic differences caused by differences in bacterial resistance and try to use lavage fluid specimens as a basis for the diagnosis of invasive pulmonary fungal infections.Methods: 1.1081 cases of submission by bronchoalveolar statistics in 2011 January-2013 year in December from the lavage fluid were collected and retrospective analysis of localbronchoalveolar lavage fluid of pathogenic bacteria distribution and drug resistance situation. 2.99 cases of 2 October December to 2014 2012 in General Hospital Affiliated to Tianjin Medical University were diagnosed patients, or patients with a clinical diagnosis of IPFI in 16 cases, as the study group, the control group of 83 cases of fungal culture positive patients with bloodstream infection in blood. In all 99 cases of patients with BAL was performed and the specimens for culture(1, 3) beta glucan detection-D, compared two groups of patients with the results of G. Analysis of patients with IPFI(1, 3)- beta glucan significance of-D detection in the diagnosis of the.Results: 1 Bacteria were 506 strains of bacteria were isolated, 472 strains of Gram-negative bacteria, accounting for 93.2%; 34 strains of Gram-positive bacteria, accounting for 6.8%. The main pathogenic bacteria were Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Bauman Acinetobacter, Acinetobacter junii, Acinetobacter lwoffii and Staphylococcus aureus. Pseudomonas aeruginosa, Acinetobacter sensitivity to Amikacin Bauman in 80%, Stenotrophomonas maltophilia in compound sulfamethoxazole showed susceptibility to high(80.6%); no vancomycin resistant Staphylococcus aureus was found. 2 BALF G test level: group IPFI, fungal culture positive patients blood group detection value of the median(four percentile interval) was 27.29, 27.64ng/L had no significant difference(P>0.05).Conclusion: The main pathogens of alveolar lavage fluid were gram negative bacilli, and the drug resistance of bacteria was serious.. This group of bacteria detection rate was 42.5%. The data of Pseudomonas aeruginosa ranks first with the sputum detection of Acinetobacter baumannii ranks first not consistent, indicating that bronchoalveolar lavage samples reflect the infection condition is more real. According to the analysis of drug sensitivity results that Pseudomonas aeruginosausing cephalosporin cefepime, imipenem, amikacin, tobramycin, gentamicin, ciprofloxacin, levofloxacin can reach the therapeutic effect. Bauman Acinetobacter can use Amikacin, tigecycline, Cefoperazone / sulbactam as guidance medication. Staphylococcus aureus was not found to glycopeptide resistant strains, in MRSA can be used as a guide to use of glycopeptide antibiotics. In the detection of pathogenic bacteria BALF specimen is more instructive. The clinical medication of pulmonary infection is more targeted. BALF fungal culture positive group and blood culture positive fungal group G test median(interquartile range) values were 27.29(17.74-64.12) ng / L, 27.64(10-149.5) ng / L. No significant differences. So the detection of G BALF can provide important evidence for the diagnosis of invasive pulmonary fungal infection.. The purpose of early diagnosis and early diagnosis.