Incidence of bacteraemia following fibreoptic bronchoscopy

Guidelines for antibiotic prophylaxis of infective endocarditis prior to fi breoptic bronchoscopy, are based on only five studies, which showed a bacte raemia rate of <1% among 291 patients studied. This study was designed to e xpand the current data regarding the frequency of bacteraemia following fib reoptic bronchoscopy. Aerobic and anaerobic cultures of venous blood and of lavage fluid were dra wn from 200 consecutive patients undergoing fibreoptic bronchoscopy without respiratory infection or antibiotic treatment prior to the procedure. The true bacteraemia rate was calculated after excluding probable "contaminated " blood cultures. A possible correlation between type of procedure performe d during the bronchoscopy and occurrence of bacteraemia was investigated. Positive blood cultures were noted following 26 bronchoscopy examinations. Coagulase negative Staphylococcus was found in the cultures of 18 patients, coagulase positive Staphylococcus in 3 patients, nonhaemolytic streptococc i and a Klebsiella species in 2 patients each, and beta haemolytic streptoc occus in one patient. After exclusion of 13 "contaminated" specimens the ba cteraemia rate was 6.5% (13/200 patients). This study showed a bacteraemia rate of 6.5%, significantly higher than pre viously recognized in a cohort of patients undergoing fibreoptic bronchosco py without either pulmonary infection or an unusually high rate of invasive procedures. These findings should be taken into account in future evaluati ons of recommendations for antibiotic prophylaxis of endocarditis.