Common respiratory viral infections: Bilateral vs unilateral bronchoalveolar lavage vs endotracheal aspiration.

Anastasiou, Olympia E; Theodoropoulos, Fotis; Taube, Christian; Fiedler, Melanie; Dittmer, Ulf

INTRODUCTION Data about the diagnostic efficiency of bilateral bronchoalveolar lavage (BAL) samples and endotracheal aspirates (EA) testing for common viral respiratory infections are scarce. PATIENTS AND METHODS We analyzed data from 167 cases, where bilateral BAL samples were tested, and from 101 cases, where BAL samples and EA were tested. Multiplex PCR was performed with the Fast Track Diagnostics viral respiratory panel, producing data on the adenovirus, coronavirus, enterovirus, human metapneumovirus, bocavirus, influenza virus, parainfluenza virus, rhinovirus and respiratory syncytial virus status of patients with respiratory disease symptoms. RESULTS In the bilateral BAL cohort, 46 (27.5%) cases were positive for at least one of the viruses mentioned above in both samples. Discrepant results (virus not detected on one side) were seen in 6 (3.6%) cases. In the BAL vs EA cohort, 12 (11.9%) cases were positive in both materials, discrepant results (only one material being positive) were observed in 11 (10.9%) cases, with 7 (63.6%) BAL samples and 4 (36.4%) EA being positive. CONCLUSIONS Bilateral sampling does not significantly improve the diagnostic efficiency of BAL for the detection of common respiratory viral pathogens via PCR. The diagnostic quality of EA and BAL samples for the detection of common viral respiratory pathogens is comparable. This article is protected by copyright. All rights reserved.