Aims and objectives

The aim of bronchoscopic secretion sampling is to identify pathogenic organisms thus cause pulmonary infections. However, bronchoscopic secretion sampling is often performed during each diagnostic or therapeutic bronchoscopy in patients without a clinical suspicion for an acute respiratory infection. Nine of twelve institutions from Austria and Germany reported to perform bronchial secretion sampling routinely during bronchoscopy. However, the clinical utility of routine bronchial secretion sampling is unknown.

Methods

In this retrospective analysis, all results from bronchial secretion sampling that were performed in 257 patients during bronchoscopies from 02/2022 until 09/2022 in the Department of Pulmonology at the Medical University of Vienna were collected. Bronchial secretion was assessed for pathogenic bacteria/fungi culture. An additional multiplex PCR assay (BioFire®) was performed in the majority of the bronchial secretion samples and compared to microbiological cultures.

Results

Microbiological cultivation and Multiplex PCR assay revealed positive results in 21% (55/257) and 25% (57/228) respectively. Matching results were found in 83% (189/228). Considering the underlying pathology, Multiplex PCR revealed positive results for 29% (4/14) of COPD, 20% (14/69) of interstitial lung disease, 16% (21/131) of cancer, 0% (0/1) of chronic cough, 44% (4/9) of hemoptysis, 14% (2/14) of asthma 20% (2/10) of long COVID and 40% (12/30) of pulmonary infections patients.

Conclusion

The clinical utility of routine bronchial secretion collection is doubtful and should be limited to cases with clinical suspicion for acute respiratory infection and hemoptysis.