A NEW BRONCHOSCOPIC TECHNIQUE FOR THE DIAGNOSIS OF BACTERIAL PNEUMONIA IN HIV-POSITIVE PATIENTS

The aim of the present study was to evaluate in HIV-positive patients with bacterial pneumonia, the diagnostic value of a new endoscopic tec hnique that uses a single catheter to perform a telescopic plugged cat heter (TPC) followed by a modified protected bronchoalveolar lavage (m pBAL). Fifty-eight HIV-positive patients with respiratory infection we re included in the study. Samples from TPC and mpBAL were cultured qua ntitatively. Standard bronchoalveolar lavage was performed to rule out opportunistic infections. According to the clinical and microbiologic al results, patients were classified in the study group (27 with bacte rial pneumonia) or the control group (31 without bacterial pneumonia). Sensitivity of TPC was 56% [95% confidence intervals (CI) 37-75%] and its specificity was 100%; these figures were 56% (CI, 37-75%) and 94% (CI, 86-100%) for mpBAL. When both techniques were assessed together, sensitivity increased to 70% (CI, 53-87%). The use of a single cathet er reduced the cost of the originally described pBAL procedure by appr oximately 50%. The use of a single catheter to perform a TPC followed by a mpBAL can improve the diagnostic yield in HIV-positive patients w ith bacterial pneumonia, and reduces its cost.