CHARACTERISTICS OF BRONCHOALVEOLAR LAVAGE FLUID IN THE DIAGNOSIS AND TREATMENT OF SEVERE COMMUNITY-ACQUIRED PNEUMONIA
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Abstract
Background: Severe community-acquired pneumonia is a high-mortality condition requiring accurate microbiological identification for targeted antibiotic therapy. Traditional sputum culture often faces challenges due to patients' respiratory failure and high contamination rates. Bronchoscopic bronchoalveolar lavage is utilized to directly collect sterile lower respiratory tract specimens. Objectives: 1. To describe the findings of bronchoscopy and bronchoalveolar lavage in patients with severe community-acquired pneumonia; 2. To compare the microbiological results of bronchoalveolar lavage fluid and expectorated sputum in patients with severe communityacquired pneumonia. Materials and methods: A cross-sectional analytical study was conducted on 50 patients with severe community-acquired pneumonia indicated for bronchoscopy at Can Tho Central General Hospital from September 2025 to January 2026. Results: Bronchoscopy predominantly revealed acute airway inflammation (90.0%) and purulent secretions (86.0%). The positive rate of bronchoalveolar lavage culture was 26.0%, with a predominance of Gram-negative pathogens, including Klebsiella pneumoniae (12.0%) and Pseudomonas aeruginosa (4.0%). A statistically significant correlation was observed between high secretion volume visualized during bronchoscopy and a positive bronchoalveolar lavage culture (p = 0.024). Approximately 36.0% of patients were unable to expectorate sputum. The microbiological agreement between bronchoalveolar lavage and sputum was extremely low (Cohen’s Kappa coefficient = -0.002). Conclusion: Bronchoscopy combined with bronchoalveolar lavage is a safe technique providing reliable microbiological results in severe community-acquired pneumonia.
Keywords
Severe community-acquired pneumonia, bronchoalveolar lavage, bronchoscopy
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References
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