BACTERIAL-FLORA OF RESPIRATORY-TRACT IN CHRONIC-BRONCHITIS - COMPARISON OF TRANSTRACHEAL, FIBER-BRONCHOSCOPIC, AND OROPHARYNGEAL SAMPLING METHODS

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Abstract
The bacterial flora of the respiratory tract was studied in 24 male patients with chronic bronchitis, 52 yr of age and older. Respiratory tract secretions from the 1st 13 subjects of the study cohort were obtained by transtracheal aspiration, endotracheal intubation followed by fiberbronchoscopic aspiration and oropharyngeal sampling with an area-sampling device. All 3 methods were highly reliable in ascertaining the presence of Haemophilus influenzae and Streptococcus pneumoniae. Agreement between any 2 of the methods was excellent. Another 11 subjects of the study cohort were studied by transtracheal aspiration and oropharyngeal sampling only, with results showing unusually good agreement. The predominant potential pathogens in tracheobronchial secretions of all 24 subjects were H. influenzae (58%) and S. pneumoniae (38%). Anaerobic bacteria were isolated in pure culture from transtracheal aspirates of 4 subjects (17%), but growth was light (<103 colony-forming units/ml). Tracheobronchial secretions harbored oropharyngeal commensals in 1/2 of the patients, but no consistent pattern emerged. In every case of concurrent upper and lower respiratory tract colonization with S. pneumoniae, serotyping revealed identical capsular antigen. None of the H. influenzae organisms was typable.

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