A Comparison of Aerobic Bacterial Culture between BAL and Induced Sputum Method on HIV-AIDS Patient with Bacterial Pneumonia CO-Infection
DOI:
https://doi.org/10.36497/jri.v39i1.37Keywords:
aerobic bacterial culture, bacterial pneumonia, bronchoalveolar lavage, human immunodeficiency virus, induced sputum.Abstract
Background: Bacterial pneumonia is the main cause of morbidity and mortality in immunocompromised individuals. The incidence of bacterial pneumonia on HIV patients is 2,3 cases per 100 people per year. On several cases, obtaining sputum sample for cultivation to confirm bacterial pneumonia diagnosis is difficult, thus further work to gain representative sample is necessary. This can be acquired through sputum induction and bronchoscopy. This study aims to compare aerobic bacteria culture result between BAL and induced sputum NaCl 3% method. Method: This is a comparative analytical study which was done in UPIPI dr. Soetomo Hospital Surabaya on HIV-positive patients between 21 – 60 years old with suspected bacterial pneumonia through clinical and radiology findings. All patients went through sputum induction and BAL procedure. The sputum obtained was cultured aerobically to confirm the diagnosis of bacterial pneumonia. Results: There were 26 subjects with average age 40 years old and male majority (73,1%). All patients were present with coughing and breahtlessness as their chief complaint, while the general complaint was coughing with difficulty in excreting sputum. The dominant risk factor is a history of free sex. The radiologic findings were dominated with unilateral infiltrate (73,1%). Most of the FOB imaging results were normal (88,5%). The results of aerobic bacterial culture from sputum induction are: Streptococcus pneumoniae (20%), Pseudomonas aeroginosa (20%), Acinetobacter spp. (20%), while from BAL method: Klebsiella pneumoniae (25%). The different specimen-obtaining method between induced sputum and BAL method has significant result with p= 0,001 (p<0,05). The positive culture result from BAL method was 61,5%. (J Respir Indo 2019; 39(1): 14-20)Downloads
References
Centers for Disease Control and Prevention: Revised classification system for HIV infection and expanded surveillance case definition for AIDS among Cadolescant and adults. MMWR Recomm Rep. 1993;269(6):729-30.
da Silva RM, Teixeira PJ, Moreira Jda S. The clinical utility of induced sputum for diagnosis of bacterial community-acquired pneumonia in HIV-infected patients: a prospective cross-sectional study. Braz J Infect Dis. 2006;10(2): 8993.
Madeddu G, Porqueddu EM, Cambosu F, Saba F, Fois AG, Pirina P, et al. Bacterial community acquired pneumonia in HIVinfected inpatients in the highly active antiretroviral therapy era. Infection. 2008; 36(3):231–6.
Jain P, Sandur S, Meli Y, Arroliga AC, Stoller JK, Mehta AC. Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest. 2004;125(2): 712-22.
Velez L, Correa L.T, Maya M.A, Mejia P, Ortega J, Bedoya V, Ortega H. Diagnostic accuracy of bronchoalveolar lavage samples in immunosuppressed patients with suspected pneumonia: analysis of a protocol. Respir Med. 2007;101(10):2160-7.
Magnenat JL, Nicod LP, Auckenthaler R, Junod AF. Mode of presentation and diagnosis of bacterial pneumonia in human immunodeficiency virusinfected patients. Am Rev Respir Dis. 1991;144(4):917–22.
Afessa B & Green W. Bacterial pneumonia in hospitalized patients with HIV infection. the Pulmonary Complications, ICU Support, and Prognostic Factors of Hospitalized Patients with HIV (PIP) Study. Chest. 2000;117(4):1017–22.
Crothers, K., Huang, L., Goulet, J. L, Goetz MB, Brown ST, Rodriquez-Barradas MC, et al. HIV infection and risk for incident pulmonary diseases in the combination antiretroviral therapy era. Am J Respir Crit Care Med. 2011;183(3):38895.
Ditjen P2PL Kemenkes RI. Situasi dan analisis HIV AIDS. [Internet]. 2014. Available from: http://www.depkes.go.id/resources/download/pusdatin/infodatin/Infodatin%20AIDS.pdf
Arcalis N, Trallero P, Lopez SM, et al. HIV related pulmonary infections. A radiologic pictorial review. European Society of Radiology. 2013. DOI 10.1594/ecr2013/C0836.
Honenadel I.A, Kiworr M, Genitsariotis R, Zeidler D, Lorenz J. Role of bronchoalveolar lavage in immunocompromised patients with pneumonia treated with a broadspectrum antibiotic and antifungal regimen. Thorax. 2001;56:11520.
Downloads
Additional Files
Published
Issue
Section
License
- The authors own the copyright of published articles. Nevertheless, Jurnal Respirologi Indonesia has the first-to-publish license for the publication material.
- Jurnal Respirologi Indonesia has the right to archive, change the format and republish published articles by presenting the authors’ names.
- Articles are published electronically for open access and online for educational, research, and archiving purposes. Jurnal Respirologi Indonesia is not responsible for any copyright issues that might emerge from using any article except for the previous three purposes.