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Bronchial Aspirates in the Diagnosis of Pulmonary Tuberculosis: Materials and Methods

This study was undertaken to investigate the clinical utility of DATs on bronchoscopic aspirates in the diagnosis of pulmonary tuberculosis, with particular regard to the possibility of false-positive results arising from cross-contamination via bronchoscopes. COBAS AMPLICOR (CA) [Roche Diagnostics Systems; Branchburg, NJ] was used as the DAT for the diagnosis of tuberculosis.
Bronchoscopic Procedures
Four hundred fiberoptic bronchoscopic procedures were performed, using seven different bronchoscopes (three model 1T200 bronchoscopes, and one each of model 1T30, model 2T10, model 3C10, and model N20 bronchoscopes; Olympus; Tokyo, Japan) on 335 consecutive patients at the Asan Medical Center from April to June 2000. The Asan Medical Center is a 2,200-bed tertiary referral center, in which seven pulmonologists perform approximately 2,000 bronchoscopic procedures per year. The mean number of bronchoscopic procedures performed in this study was 8.3/d (400 procedures in 48 days; range, 2 to 14/d). Bronchoscopy was performed for therapeutic purposes in 14 patients and for diagnostic purposes in the remaining subjects. Canadian drug mall further In 35 patients, bronchoscopy was performed more than once. All 400 bronchial aspirates were collected and tested for M tuberculosis using CA, independent of any suspicion of pulmonary tuberculosis. Between patient use, the seven bronchoscopes were cleaned and disinfected automatically by the same bronchoscope washer (EW-20 system; Olympus). With the exception of shortening the disinfection cycle from 20 to 10 min, our cleaning and disinfection protocol was within the guidelines proposed by the Association for Professionals in Infection Control (APIC) and the manufacturer of the bronchoscopes. Immediately following a procedure, the lumen was irrigated with 10 mL of 70% alcohol, after which the bronchoscopic surface was cleaned with saline solution gauze.