Role of Routine Bronchial Washing Culture for TB in Maharat Nakhon Ratchasima Hospital, Thailand

Nabhathara Kheawon MD*, Suthanya Chuang-ngam RN*, Suparat Mitsoongneun RN*, Janisaya Peam-am RN*, Jarukorn Visalsawadi MSc**

Affiliation : * Division of Pulmonary and Critrical, Department of Medicine, Maharat Nakhorn Ratchasima Hospital, Nakhon Ratchasima, Thailand ** Division of Laboratory, Maharat Nakhorn Ratchasima Hospital, Nakhon Ratchasima, Thailand

Objective : To evaluate the role of routine bronchial washings (BW) culture for diagnostic sputum smear negative pulmonary case of tuberculosis (TB) at Maharat Nahkon Ratchasima Hospital. Material and Method: A retrospective, observational study of performed bronchial washing (BW) specimens from 93 patients who met presumptive criteria of smear negative case of pulmonary TB was done. The culture of BW for TB was done by conventional technique. All of the BW specimens were not centrifuged before AFB stain. Pathological reports were included in the study. Statistical analysis was described as percentage.
Results : Ninety-three patients were included in the presented study. Eighty-seven patients had a diagnosis of smear-negative pulmonary case of TB (93.5%). The un-centrifuged BW smear for AFB was positive in 17 (18.3%) patients while conventional culture of BW for TB was positive in 34 (36.6%) patients. The MDRTB and NTM were positive in one (1.1%) and five (5.4%) patients respectively. The positive un-centrifuged BW smear for AFB in the MDRTB and NTM patients were 0 and 2/5 (40%) respectively. The pathological reported granulomatous disease was found in 18 (19.4%) patients. Five (5.4%) patients had all positive of any methods while 45 (48.4%) patients had all negative tests.
Conclusion : The routine culture BW for TB should be done in every case of presumptive diagnosis of sputum smear negative pulmonary case of TB. Furthermore, it can establish that MDRTB and NTM cannot be identified with only AFB stain.

Keywords : Routine bronchial washing, Tuberculosis mycobacterium, Bronchoscopic examination, Sputum smear negative

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