Usefulness of Post-bronchoscopy Sputum Culture for Diagnosis of Nontuberculous Mycobacterial Pulmonary Disease

• Published in: Journal of Korean medical science 2021, 36(31), , pp.1-8
• Main Authors: Gu, Kang Mo, Kang, Hye Rin, Park, Jimyung, Kwak, Nakwon, Yim, Jae Joon
• Format: Article
• Language: English
• Subjects: Aged; Bronchoalveolar Lavage; Bronchoscopy - methods; Cohort Studies; Humans; Lung Diseases - diagnosis; Lung Diseases - epidemiology; Lung Diseases - microbiology; Male; Middle Aged; Mycobacterium Infections, Nontuberculous - diagnosis; Mycobacterium Infections, Nontuberculous - epidemiology; Nontuberculous Mycobacteria - isolation & purification; Original; Republic of Korea - epidemiology; Retrospective Studies; Sensitivity and Specificity; Sputum - microbiology; 의학일반
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2021.36.e202

Bronchoscopy is recommended for patients with suspected nontuberculous mycobacterial pulmonary disease (NTM-PD) whose sputum culture results are consistently negative or from whom adequate sputum samples cannot be obtained. Post-bronchoscopy sputum (PBS) collection is recommended for patients with suspected tuberculosis who undergo bronchoscopy. However, it remains unclear whether PBS collection can increase the diagnostic yield of NTM-PD. Patients with suspected NTM-PD who underwent diagnostic bronchoscopy from January 1, 2017 to June 30, 2020 at the Seoul National University Hospital were included in the study. They were divided into the sputum culture-negative and scanty sputum groups. The results of mycobacterial cultures from bronchial washing specimens and PBS were compared between these groups. In total, 141 patients were included in the study; there were 39 and 102 patients in the sputum culture-negative and scanty sputum groups, respectively. Nontuberculous mycobacteria were cultured from bronchial washing specimens collected from 38.3% (54/141) of all patients (30.7% [12/39] patients in the sputum culture-negative group and 41.2% [42/102] patients in the scanty sputum group; = 0.345). Nontuberculous mycobacteria were exclusively cultured from PBS collected from 3.5% (5/141) of all patients (7.7% [3/39] patients in the sputum culture-negative group and 2.0% [2/102] patients in the scanty sputum group; = 0.255). Additional PBS collection improved diagnostic yield marginally in patients with suspected NTM-PD who undergo bronchoscopy.