Bronchoscopy and Bronchoalveolar Lavage in Children with Lower Airway Infection and Most Common Pathologic Microorganisms Isolated

Bronchoscopy and Bronchoalveolar Lavage in Children with Lower Airway Infection and Most Common Pathologic Microorganisms Isolated The study represents a review of most common pathologic microorganisms with persistent lung infiltrates in the bronchoalveolar lavage (BAL) of paediatric patients. The aim of the paper was to present the results of bronchoscopy and broncho-alveolar lavage in children with persistent lung infiltrates and most common pathologic microorganisms isolated in bronchoalveolar lavage. This is a prospective and retrospective study. Information on the paediatric findings and BAL results of bronchoscopy were obtained from the hospital records. The records of fifty patients were analyzed. All patients had persistent lung infiltrates (lower airway infection). BAL was performed in the middle lobe and lingula by bronchoscope (Olympus 3,5 mm) and sent for microbiological analysis. There was no serious desaturation during bronchoscopy. Bronchoscopy was performed under general anesthesia (sedation, propofol, midazolam, morphium). The most common pathologic microorganisms identified in BAL were: Streptococcus α haemoliticus (16%), Pseudomonas aeruginosa (12%) followed by Candida albicans (10%) and Klebsiella pneumoniae (8%). Our study results have shown that bronchoscopy with BAL is recommended for isolating bacteria as causes of lung infection and is particularly suitable for proving pneumonias caused by microorganisms. Bronhoskopija i bronhoalveolarna lavaža kod dece sa infekcijom donjih disajnih puteva i najčešće izolovanim patogenim mikroorganizmima Ova studija predstavlja pregled najčešćih patoloških mikroorganizama koji su uzročnici plućnih in-filtrata, izolovanih u bronhoalveolarnom lavatu (BAL) pedijatrijskih bolesnika. Cilj rada bio je da prikaže rezultate bronhoskopije i BAL-a kod dece sa perzistentnim plućnim infiltratima i izolovane patološke mikroorganizme kod BAL-a. Studija je prospektivna i retrospektivna. Analizirani su mikrobiološki nalazi u BAL-u kod 50 hospitalizovane dece. Sva ispitivana deca imala su perzistentne plućne infiltrate (infekcije donjih disajnih puteva). BAL je rađen u srednjem lobusu ili linguli sa bronhoskopom 3,5mm (Olympus). Bronhoskopija je rađena u opštoj anesteziji (sedacija propofol, midazolam, morfijum). Uzorak je dat na mikrobiološki pregled (biogram i antibiogram, bojenje po Gramu). Nije bilo ozbiljnijeg pada saturacije tokom izvođenja bronhoskopije. Najčešće izolovani mikrobiološki patogeni u BAL-u su: Streptococcus α haemoliticus (16%), Pseudomonas aeruginosa (12%), Candida albicans i Klebsiella pneumoniae (8%). Naši rezultati su pokazali da je bronhoskopija sa BAL-om metoda izbora za izolovanje bakterija koje su uzročnici plućnih infekcija donjih delova respiratornog trakta kod dece.