Needle wash solution cultures following EBUS-TBNA with or without endobronchial intubation

Daisuke Minami, Nagio Takigawa, Masahide Oki, Hideo Saka, Takuo Shibayama, Katsuyuki Kiura

Research output: Contribution to journalArticle

Abstract

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure with a high diagnostic yield in lesions adjacent to the airways. However, complications associated with EBUS-TBNA, such as mediastinitis, have recently been reported. Oral bacteria contamination in punctured lymph nodes can cause severe infections. In the current study, we investigated whether endobronchial intubation using EBUS-TBNA can prevent oral bacterial contamination of punctured lymph nodes. Methods: We retrospectively evaluated 80 patients (102 lymph nodes) who had undergone EBUS-TBNA and divided them two groups: Group A comprised 60 patients who had undergone EBUS-TBNA with endobronchial intubation and Group B consisted of 20 patients who had undergone EBUS-TBNA without endobronchial intubation. The patients’ medical records were examined and the two groups were compared using the unpaired Student's t-test. Results: EBUS-TBNA needle wash cultures were positive in only two Group A cases (3.3%), but in all 20 Group B cases (100%) (P < 0.05). Except for one case of Mycobacterium tuberculosis, all bacterial isolates yielded typical oropharyngeal commensal flora. Fever (≥ 38.0 °C) was observed in six Group A cases (10%) and two Group B cases (10%; P = 0.526). This was treated by cooling, a single administration of non-steroidal anti-inflammatory drugs, and/or antibiotic therapy. Fever was not associated with any clinical features, including malignancy in punctured lesions, number of punctures, echo features, simultaneous peripheral biopsy, additional oral prophylactic antibiotics, or positive needle wash cultures. Conclusions: Endobronchial intubation may prevent contamination by oropharyngeal commensal bacteria.

Original languageEnglish
JournalRespiratory Investigation
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Intubation
Needles
Lymph Nodes
Fever
Anti-Bacterial Agents
Bacteria
Mediastinitis
Punctures
Mycobacterium tuberculosis
Medical Records
Anti-Inflammatory Agents
Students
Biopsy
Infection
Pharmaceutical Preparations

Keywords

  • Endobronchial intubation
  • Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)
  • Infectious complications
  • Needle wash solution

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Needle wash solution cultures following EBUS-TBNA with or without endobronchial intubation. / Minami, Daisuke; Takigawa, Nagio; Oki, Masahide; Saka, Hideo; Shibayama, Takuo; Kiura, Katsuyuki.

In: Respiratory Investigation, 01.01.2018.

Research output: Contribution to journalArticle

Minami, Daisuke ; Takigawa, Nagio ; Oki, Masahide ; Saka, Hideo ; Shibayama, Takuo ; Kiura, Katsuyuki. / Needle wash solution cultures following EBUS-TBNA with or without endobronchial intubation. In: Respiratory Investigation. 2018.
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abstract = "Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure with a high diagnostic yield in lesions adjacent to the airways. However, complications associated with EBUS-TBNA, such as mediastinitis, have recently been reported. Oral bacteria contamination in punctured lymph nodes can cause severe infections. In the current study, we investigated whether endobronchial intubation using EBUS-TBNA can prevent oral bacterial contamination of punctured lymph nodes. Methods: We retrospectively evaluated 80 patients (102 lymph nodes) who had undergone EBUS-TBNA and divided them two groups: Group A comprised 60 patients who had undergone EBUS-TBNA with endobronchial intubation and Group B consisted of 20 patients who had undergone EBUS-TBNA without endobronchial intubation. The patients’ medical records were examined and the two groups were compared using the unpaired Student's t-test. Results: EBUS-TBNA needle wash cultures were positive in only two Group A cases (3.3{\%}), but in all 20 Group B cases (100{\%}) (P < 0.05). Except for one case of Mycobacterium tuberculosis, all bacterial isolates yielded typical oropharyngeal commensal flora. Fever (≥ 38.0 °C) was observed in six Group A cases (10{\%}) and two Group B cases (10{\%}; P = 0.526). This was treated by cooling, a single administration of non-steroidal anti-inflammatory drugs, and/or antibiotic therapy. Fever was not associated with any clinical features, including malignancy in punctured lesions, number of punctures, echo features, simultaneous peripheral biopsy, additional oral prophylactic antibiotics, or positive needle wash cultures. Conclusions: Endobronchial intubation may prevent contamination by oropharyngeal commensal bacteria.",
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