Distribution of Major Pathogens from Sputum and Bronchoalveolar Lavage Fluid in Patients with Noncystic Fibrosis Bronchiectasis： A Systematic Review

• Published in: Chinese medical journal Vol. 128; no. 20; pp. 2792 - 2797
• Main Authors: Miao, Xia-Yi, Ji, Xiao-Bin, Lu, Hai-Wen, Yang, Jia-Wei, Xu, Jin-Fu
• Format: Journal Article
• Language: English
• Published: China Medknow Publications Pvt Ltd 20.10.2015; Medknow Publications and Media Pvt. Ltd; Lippincott Williams & Wilkins Ovid Technologies; Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China; Medknow Publications & Media Pvt Ltd; Wolters Kluwer
• Subjects: Bacteria; Bronchiectasis; Bronchiectasis - microbiology; Bronchiectasis; Bronchoalveolar Lavage Fluid; Pathogens; Sputum; Bronchoalveolar Lavage Fluid - microbiology; Care and treatment; Cystic fibrosis; Diagnosis; English language; Haemophilus influenzae - pathogenicity; Humans; Medicine; Methods; Pseudomonas aeruginosa - pathogenicity; Review; Sputum - microbiology; Streptococcus infections; Studies; Thorax; 患者; 支气管肺泡灌洗液; 病原菌; 系统; 纤维化; 细菌培养; 金黄色葡萄球菌; 铜绿假单胞菌; China; Bronchoalveolar Lavage Fluid; Pathogens; Bronchiectasis; Sputum
• ISSN: 0366-6999; 2542-5641
• DOI: 10.4103/0366-6999.167360

Objective： Noncystic fibrosis （non-CF） bronchiectasis remains as a common health problem in Asia. Pathogens＇ distribution in airways of patients with non-CF bronchiectasis is important for doctors to make right decision. Data Sources： We performed this systematic review on the English language literatures from 1966 to July 2014, using various search terms included ＂pathogens＂ or ＂bacteria＂ or ＂microbiology＂ and ＂bronchiectasis＂ or ＂non-cystic fibrosis bronchiectasis＂ or ＂non-CF bronchiectasis＂ or ＂NCFB.＂ Study Selection： We included studies of patients with the confirmed non-CF bronchiectasis for which culture methods were required to sputum or bronchoalveolar lavage fluid （BALF）. Weighted mean isolation rates for Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Stapylococcus aureus, Moxarella catarrhails were compared according to different methodology. Results： The total mean bacterial culture positive rates were 63%. For studies using sputum samples, the mean positive culture rates were 74%. For studies using BALF alone or BALF and sputum, it was 48%. The distributions of main bacterial strains were 29% for 1-1. influenzae, 28% for P. aeruginosa, 11% for S. pneumoniae, 12% for S. aureus, and 8% for M. catarrhails with methodology of sputum. Meanwhile, the bacterial distributions were 37% for H. influenzae, 8% for P aeruginosa, 14% for S. pneumoniae, 5% for S. attretts, and 10% for M. catarrhails with methodology of BALF alone or BALF and sputum. Analysis of the effect of different methodology on the isolation rates revealed some statistically significant differences. Conclusions： H. influenzae accounted for the highest percentage in different methodology. Our results suggested that the total positive culture rates and the proportion of P. aeruginosa from sputum and BALF specimens had significant differences, which can be used in further appropriate recommendations for the treatment of non-CF bronchiectasis.