Is routine bronchoscopic culture indicated in areas with low tuberculosis prevalence?
OBJECTIVE: To determine the value of routine culture of bronchoscopy samples for mycobacteria even when tuberculosis (TB) is not strongly suspected in low TB prevalence areas.
DESIGN: A prospective study of 362 consecutive patients who underwent a bronchoscopy procedure. All demographic, clinical and computed tomography findings, and bacterial and mycobacterial culture results were collected.
RESULTS: A total of 217 men and 145 women, with a mean age of 63 ± 15 years, were included in the study. All underwent bronchoscopy with routine culture for TB. Ten cultures (2.8%) grew mycobacteria: 2 (0.55%) Mycobacterium tuberculosis and 8 (2.2%) non-tuberculous mycobacteria (NTM). The NTM included M. avium complex (MAC) in six patients and M. simiae in two patients. Two patients had two different mycobacteria species: 1 patient with M. simiae and MAC and the other with TB and MAC. All eight patients were negative for microscopy.
CONCLUSION: Based on our results, we suggest that routine culture of bronchial specimens for TB is not indicated in patients with a low clinical suspicion of active TB in countries with a low TB burden.
Keywords: clinical suspicion; cost savings; prevalence; routine lavage; tuberculosis
Document Type: Research Article
Affiliations: Pulmonary Department, Meir Medical Center, Kfar Saba, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Publication date: 01 August 2013
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