Clinical evaluation of bacterial colonization of bronchiectasis

ABSTRACT

Background: Bronchiectasis is a chronic pulmonary disease characterized by abnormal irreversible dilatation of one or more bronchi often with wall thickening. In Bronchiectasis initial colonization of the lower respiratory tract by different microorganisms as the first step leading to the inflammatory response. Persistence of microorganisms in the airways because of impairment in mucus clearance may lead to a vicious circle of events characterized by chronic bacterial colonization, persistent inflammatory reaction and progressive tissue damage and morbidity life. Aim of the study To evaluate the Bronchial inflammatory response and its relationship to bacterial colonization in Bronchiectasis. Materials and methods: This study was done for a period of 7 months from February 2016 to August 2016 in Department of Thoracic Medicine, Government Villupuram Medical College and Hospital, Villupuram. The Bacterial flora from Lower Respiratory tract of Bronchiectasis patients who attended the Thoracic medicine outpatient department with diagnosis confirmed by a radiologist were studied. Bronchoalveolar lavage was done as an invasive procedure in 90 patients with bronchiectasis and from 6 patients admitted with chronic upper respiratory symptoms as laboratory control in Interleukin-8 estimation. Results: Among 90 study population, analysis showed females were 58% and males were 42%. Cylindrical bronchiectasis 53%, followed by cystic bronchiectasis 36% in predominance and positive culture growth rate for sputum samples were 68% and BAL samples were 77%. The microorganisms isolated predominantly were H. influenza, Pseudomonas, Streptococci, Staphylococci, and etc. R. Nedunchezhian, A. Sundrarajaperumal, D. Ranganathan, V. Sundar. Clinical evaluation of bacterial colonization of bronchiectasis. IAIM, 2019; 6(6) 92-99. Page 93 Conclusion: Increased incidence of bronchiectasis in females (58%). Cylindrical bronchiectasis was the commonest type followed by Cystic bronchiectasis regarding etiology of Bronchiectasis, 42% of bronchiectasis was Idiopathic followed by post infectious 21%. With the concordant value of 75% for sputum culture and bronchoalveolar lavage fluid culture, the Sputum culture is the non-invasive, alternative technique for bronchoalveolar lavage fluid culture