PULMONARY INFECTIONS IN LUNG-CANCER PATIENTS AT DIAGNOSIS

We carried out a prospective study involving 96 consecutive lung cance r patients at diagnosis, in order to determine through quantitative cu ltures of the bronchoalveolar lavage (BAL) fluid, the prevalence of pu lmonary infections; we also evaluated the relationship between a patie nt's performance status, immunocompetence, lung cancer stage, histotyp e and the occurrence of respiratory infections. The patients (81 males , 15 females) had a mean age of 64 +/- 9 years. Of these, 62 were smok ers, 30 were ex-smokers and four had never smoked. Sixty-seven patient s had a prior history of chronic bronchitis. A total of 42 micro-organ isms were cultured from the BAL fluids of 33 patients (34.3%). Fifty p ercent of these micro-organisms were gramnegative, 33.3% were gram-pos itive and the remaining 16.7% were other micro-organisms. The bacilli most often isolated were the Haemophilus species, accounting for 38.8% of all gramnegative bacilli. The most frequently isolated gram-positi ve pathogen was the Staphylococcus aureus. We have not found a signifi cant relationship between the presence of a respiratory infection and the different cell types separately analyzed, nor with SCLC and NSCLC patient groups, nor with the stage of the disease. The performance sta tus, the immunoregulatory ratio and the lymphocyte subsets were not si gnificantly different in patients with or without a pulmonary infectio n. We think that the identification of a definite etiologic agent is o f great importance for a rational anti-microbial treatment of pulmonar y infections.