Application value of new type of electronic fiberoptic bronchoscope for anti-contamination bronchoalveolar lavage, bronchoalveolar lavage and routine sputum detection in the diagnosis and treatment of pulmonary infection

Objective To investigate the application value of anti-contamination bronchoalveolar lavage (PBAL), bronchoalveolar lavage (BAL) and routine sputum detection in the diagnosis and treatment of pulmonary infection by electronic fiber bronchoscopy. Methods Total of 85 patients with pulmonary infection admitted to Hefei Second People’s Hospital from January 2016 to October 2017 were selected, randomly. All patients underwent PBAL, BAL and routine sputum detection, also combined with image detection. The detection rate of pathogenic bacteria and the total effective rate after clinical treatment were analyzed by the above three methods. Results A total of 255 specimens were collected from 85 patients, and 163 strains of pathogens were cultured. The total positive rate was 63.92%. The detection rates of PBAL, BAL and routine sputum detection were 80.00% (68/85), 67.06% (57/85) and 44.70% (38/85), respectively. The detection rates of pathogens by PBAL method and routine sputum detection were significantly different (χ2 = 12.582, P < 0.001), but without significant difference compared with the detection rate of pathogens by BAL method (χ2 = 1.570, P = 0.210). The detection rate of pathogens by BAL method and routine sputum detction were significantly different (χ2 = 5.363, P = 0.021). Gram-negative bacteria accounted for 69.33% (113/163), Gram-positive bacteria accounted for 24.54% (40/163), and fungi accounted for 6.13% (10/163) of the total number of pathogens by three methods. The results of drug sensitivity test after sampled by PBAL, BAL and routine sputum showed that the average resistance rates of Gram-negative bacteria were (87.34 ± 5.52)%, (76.13 ± 6.33)% and (66.65 ± 4.85)%, with significant difference (F = 115.531, P < 0.001); the average sensitivity were (82.12 ± 4.79)%, (72.54 ± 6.14)% and (62.74 ± 4.65)%, with significant difference (F = 114.712, P < 0.001). The results of drug sensitivity test after sampled by PBAL, BAL and routine sputum showed that the average resistance rates of Gram-positive bacteria were (85.45 ± 5.13)%, (73.24 ± 4.87)% and (65.37 ± 5.13)%, with significant difference (F = 54.626, P < 0.001); while the average sensitivity were (80.56 ± 4.67)%, (69.42 ± 4.65)% and (61.34 ± 4.25)%, with significant difference (F = 61.114, P < 0.001). Total of 68 patients with positive bacterial culture were tested for antimicrobial susceptibility according to the above three sampling methods, the total effective rate of PBAL was 88.24% (56/68), which was significantly higher than that of BAL [73.68% (42/57)] and routine sputum detction [52.63% (20/38)], with significant difference (χ2 = 4.372, P = 0.036; χ2 = 16.692, P < 0.001). The total effective rate of BAL method was significantly higher than that of the routine sputum detection (73.68% vs. 52.63%; χ2 = 4.458, P = 0.035). The total effective rate of PBAL was significantly higher than that of BAL (88.24%vs. 73.68%), with significant difference (χ2 = 4.372, P = 0.036). Conclusions The pathogenic detection rate and total effective rates of anti-pollution tracheal alveolar lavage and anti-contamination tracheal lens alveolar lavage sampled by drug susceptibility test after adjusting antibacterial drugs, the total effective rate is higher than of BAL. The total effective rate of anti-pollution PBAL is higher than that of BAL, suggesting that it has higher application value. Key words: Pulmonary infection; Anti-pollution fiberoptic bronchoscopy; Alveolar lavage; Routine sputum detction