Bronchoscopy in suspected @entity358 with negative induced-sputum smear and XXXX (  ) Gen-probe testing.

@entity1 @entity21035 @entity14728 @entity645 @entity1906 @entity358
INTRODUCTION: In our institution, @entity1 with suspected @entity358 undergo multiple induced-sputum sampling for microscopy, culture and nucleic acid amplification (NAA) with the @entity21035 (  ) Gen-probe assay. Those with negative induced-sputum results still suspected with @entity1906 are then referred for bronchoscopy. We sought to determine the diagnostic yield of bronchoscopy in these @entity1 with negative initial induced-sputum results both via smear and @entity14728 testing. METHODS: We identified 30 consecutive cases of suspected @entity358 between 2001 and 2007, who had undergone a diagnostic bronchoscopy after negative results on induced-sputum smears and the @entity21035 (  ) Gen-probe on at least 2 samples. RESULTS: The cohort (M = 20 _ F = 10) had a median age of 37 (range 16-85 yrs); were predominantly foreign born (27/30); @entity645 -negative (29/30) individuals with strongly positive TST's (mean 18 + 5 mm). Induced-sputum cultures were negative for M- @entity1906 in all @entity1 after a full 60-day incubation period. BAL was culture positive for M- @entity1906 in 3/30 cases (10%) with 2 strains being pan-sensitive and the third being INH resistant. BAL microscopy with acid-fast smear (n = 30) and BAL Gen-probe (n = 23) were negative in all cases. A third of the @entity1 (9/27, 33%) with negative bronchoscopy results were treated for culture negative @entity1906 . Treatment for @entity1906 was initiated in 5/27 (18%) individuals whereas 13/27 (48%) received no further treatment. CONCLUSION: Bronchoscopy provided diagnostic confirmation of @entity358 in 10% of subjects at least 2 negative induced-sputum samples by smear microscopy and NAA testing.
