RESUMEN
INTRODUCTION: The ineffectiveness of microbiological methods in the lower respiratory tract infections are caused by anachronistic sampling methods. Authors checked the protected specimen brush effectiveness and those of the influencing factors. MATERIALS AND METHODS: 103 patients were involved in the study. The causative agents were identified in 44 cases. These results were compared to last year's classic sampling techniques and they experienced 20.4% improvement of the sensitivity. Further increasing in effectiveness can be reached if we perform bacteriological sampling after the first unsuccessful antibiotic treatment was performed. Out of 103 examined patients only 69 underwent antibiotic treatment. In the case of 13 patients after the course of one type antibiotic treatment 10 positive bacteriological cultures were positive. In the case of 31 patients 2 types of antibiotics were administered sequentially and examined afterwards and the authors found 15 positive bacteriological cultures. In the case of 25 patients the administered sequentially 3 times of antibiotics and examined afterwards, 6 cultures were positive. CONCLUSION: The examinations prove that the protected specimen brush, used in time, raises the sensitivity of microbiological processes.
Asunto(s)
Broncoscopios , Broncoscopía/métodos , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/microbiología , Adulto , Anciano , Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/microbiología , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/microbiología , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/microbiología , Neoplasias del Sistema Respiratorio/diagnóstico , Neoplasias del Sistema Respiratorio/microbiología , Manejo de Especímenes/instrumentación , Manejo de Especímenes/métodosRESUMEN
INTRODUCTION: Routine stool culture is used to evaluate patients with diarrheal illness. However, the results are often delayed, and the tests are very expensive. Therefore a rapid, simple method for screening would be a helpful adjunct in a diagnostic algorithm. Fecal leukocytes are found in diarrhea patients with diffuse colonic inflammation but missing in non-inflammatory cases, and are most commonly identified in infectious diarrheas of bacterial origin. It supports the use of immediate empiric therapy in very young, elderly and immunocompromised individuals. When negative, it may eliminate the need for stool culture in some cases of diarrhea. Recently, a new latex bead assay has been developed for the detection of lactoferrin, an iron binding glycoprotein found in polymorphonuclear leukocytes. AIMS: Evaluate the value of fecal leukocytes and lactoferrin in the workup of patients with diarrhea. METHODS: Fecal samples of 50 consecutive adult patients with acute or chronic diarrhea were tested for fecal leukocytes and lactoferrin. The results were compared with findings from fecal cultures, tests for parasite, Clostridium difficile A toxin latex test, data of the gastrointestinal examination and clinical evaluation. The authors defined two groups of the cases: the inflammatory and non-inflammatory diarrheas. RESULTS: The sensitivity, specificity, positive and negative predictive value of microscopic leukocyte count and the lactoferrin test were 42 and 63%, 87 and 87%, 67 and 75%, 71 and 79% respectively. CONCLUSIONS: In agreement with the literature the results of the present study indicate that fecal lactoferrin appears more sensitive than fecal leukocyte smear, and accurately rules out inflammatory diarrhea.