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KMID : 0882419760190050397
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Korean Journal of Medicine
1976 Volume.19 No. 5 p.397 ~ p.404
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Bacteriological Studies of the Various Pulmonary Diseases by Transtracheal Aspiration
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Hong Chein-Soo
Paek Chong-Youl
Woo Myung-Sook
Lee Won-Young
Kim Ki-Ho
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Abstract
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The examination of expectorated sputum is not always a reliable indicator of the organisms present in the lower respiratory tract because it is contaminated by mouth flora. Some maneuvers designed to reduce the error have been introduced in sampling of pulmonary secretions through a bronchoscope, repeated washing of expectorated sputum, and quantitative culture. There procedures cannot differentiate organisms coming from the upper respiratory -tract from those in the lower respiratory tract.
In 1959 Pecora proposed transtrachealaspiration as a method of obtaining material from the lowei resy piratory tract. Subsequent reports have confirmed the safety and bacteriologic validity of this procedure.
The purpose of this report is to relate experience With this procedure of transtracheal aspiration and the results of aerobic and anaerobic cultures in patients with suspected infection in various pulmonary diseases.
1.- Patients: Fifty-five patients who were admitted to Yonsei Medical Center received transtracheal aspiratoin.
2. Method: A modification of the technique for -transtracheal aspiration described by Kalinske et al. in 1967 had been applied.
3. Bacteriological Method: Specimens obtained -through transtracheal aspiration were processed immediately after collection. Both specimens obtained through TTA and expectorated sputum were examined by gramstain of direct smears, and by culture methods. The cultures were done for bothaerobic and anaerobilc bacteriae in the TTA series, but ony aerobic culture for expectorated sputum.
The results were as follow:
1. Bacterial culture of TTA specimens yielded no organisms in 81.7% out of 33 cases in which no organisms were found on direct gram stain. But bacterial cultures of TTA specimens revealed organisms in 86.4% out of 22 cases in which organisms were found on direct gram stain.
3. No organisms have beef isolated by TTA from patients with cardiovascular diseases with non-infectious pulmonary complications. Therefore, TTA will be of benefit for the differential diagnosis between bacterial infections and non-bacterial diseases when there is apulmonary infiltration on a chest film.
4. Complications following TTA were noted in 10 cases (18.2%) and were subcutaneous emphysema in 7 cases, hemoptysis in 3, local infection in 1, dyspnea in 1 and dysphagia in 1. But these complications were mild and transient, and also lasted only one or two days.
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