Is there a role for lung or bronchial biopsies for the diagnosis of mycobacterial pulmonary disease in patients with bronchiectasis?

Rottem Kuint*, Avraham Abutbul, Zvi G. Fridlender, Uri Laxer, Neville Berkman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Workup of bronchiectasis patients mandates microbiological characterization often being sought via Bronchoscopy. However, whether to perform bronchial or lung biopsies, is unknown, especially for the diagnosis of NTM pulmonary disease. We aimed to assess the current practice and yield of the different bronchoscopic procedures in this setting. Methods: Data from an adult cohort with bronchiectasis referred for bronchoscopy for microbiologic sampling was reviewed, including demographics, etiology, imaging and results of the different bronchoscopic procedures performed. Results: 127 subjects were analyzed (mean age 61, 56% female). BAL culture was positive in 44%. Frequent pathogens were Hemophilus Influenza (20%), pseudomonas aeruginosa (8%) and Staphylococcus aureus (7%). NTM and tuberculosis were found in 6% and 1.5% respectively. BAL cytology was sent in 125 procedures, EBB was performed in 51 patients (40%) and TBLB in 38 patients (30%). BAL cytology and both EBB and TBB (including tissue cultures) had no benefit over BAL with respect to microbiological diagnosis, including identification of mycobacterial disease. Conclusions: In adult subjects with Non-CF bronchiectasis requiring bronchoscopy for microbiological characterization, BAL cytology and lung tissue biopsies were frequently performed but were of minimal additional benefit over BAL culture (including for mycobacterial pulmonary disease), and are most likely futile.

Original languageAmerican English
Article number100447
JournalJournal of Clinical Tuberculosis and Other Mycobacterial Diseases
Volume36
DOIs
StatePublished - Aug 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Keywords

  • Bronchoalveolar lavage
  • Bronchoscopy
  • Non tuberculous mycobacteria
  • Respiratory infections
  • Transbronchial biopsies

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