{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:17:57Z","timestamp":1762917477093},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2013,9,2]],"date-time":"2013-09-02T00:00:00Z","timestamp":1378080000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Flexible bronchoscopy with bronchial washing is a useful procedure for diagnosis of pulmonary tuberculosis (TB), when a patient cannot produce sputum spontaneously or when sputum smears are negative. However, the benefit of gaining serial bronchial washing specimens for diagnosis of TB has not yet been studied. Therefore, we conducted a retrospective study to determine the diagnostic utility of additional bronchial washing specimens for the diagnosis of pulmonary TB in suspected patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective analysis was performed on 174 patients [sputum smear-negative, n\u2009=\u200995 (55%); lack of sputum specimen, n\u2009=\u200979 (45%)] who received flexible bronchoscopy with two bronchial washing specimens with microbiological confirmation of pulmonary TB in Samsung Medical Center, between January, 2010 and December, 2011.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Pulmonary TB was diagnosed by first bronchial washing specimen in 141 patients (81%) out of 174 enrolled patients, and an additional bronchial washing specimen established diagnosis exclusively in 22 (13%) patients. Smear for acid-fast bacilli (AFB) was positive in 46 patients (26%) for the first bronchial washing specimen. Thirteen patients (7%) were positive only on smear of an additional bronchial washing specimen. Combined smear positivity of the first and second bronchial washing specimens was significantly higher compared to first bronchial washing specimen alone [Total cases: 59 (34%) vs. 46 (26%), p\u2009&lt;\u20090.001; cases for smear negative sputum: 25 (26%) vs. 18 (19%), p\u2009=\u20090.016; cases for poor expectoration: 34 (43%) vs. 28 (35%), p\u2009=\u20090.031]. The diagnostic yield determined by culture was also significantly higher in combination of the first and second bronchial washing specimens compared to the first bronchial washing. [Total cases: 163 (94%) vs. 141 (81%), p\u2009&lt;\u20090.001; cases for smear negative sputum: 86 (91%) vs. 73 (77%), p\u2009&lt;\u20090.001; cases for poor expectoration: 77 (98%) vs. 68 (86%), p\u2009=\u20090.004].<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Obtaining an additional bronchial washing specimen could be a beneficial and considerable option for diagnosis of TB in patients with smear-negative sputum or who cannot produce sputum samples.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-13-404","type":"journal-article","created":{"date-parts":[[2013,9,2]],"date-time":"2013-09-02T08:14:35Z","timestamp":1378109675000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Additional role of second washing specimen obtained during single bronchoscopy session in diagnosis of pulmonary tuberculosis"],"prefix":"10.1186","volume":"13","author":[{"given":"Hongseok","family":"Yoo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae-Uk","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won-Jung","family":"Koh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyeongman","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Won","family":"Um","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gee Young","family":"Suh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man Pyo","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hojoong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O Jung","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nam Yong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sookyoung","family":"Woo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Yun","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,9,2]]},"reference":[{"key":"2608_CR1","unstructured":"Global Tuberculosis Control 2011. 2011, Geneva: WHO, http:\/\/www.who.int\/tb\/publications\/global_report\/2011\/gtbr11_full.pdf [last accessed 2012 Jul 24"},{"key":"2608_CR2","volume-title":"Treatment of Tuberculosis: guidelines","author":"WHO","year":"2010","unstructured":"WHO: Treatment of Tuberculosis: guidelines. 2010, WHO, http:\/\/whqlibdoc.who.int\/publications\/2010\/9789241547833_eng.pdf, 4,","edition":"4"},{"issue":"8","key":"2608_CR3","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1136\/thx.37.8.598","volume":"37","author":"PA Willcox","year":"1982","unstructured":"Willcox PA, Benatar SR, Potgieter PD: Use of the flexible fibreoptic bronchoscope in diagnosis of sputum-negative pulmonary tuberculosis. Thorax. 1982, 37 (8): 598-601. 10.1136\/thx.37.8.598.","journal-title":"Thorax"},{"issue":"3","key":"2608_CR4","first-page":"154","volume":"72","author":"S Wongthim","year":"1989","unstructured":"Wongthim S, Udompanich V, Limthongkul S, Charoenlap P, Nuchprayoon C: Fiberoptic bronchoscopy in diagnosis of patients with suspected active pulmonary tuberculosis. J Med Assoc Thai. 1989, 72 (3): 154-159.","journal-title":"J Med Assoc Thai"},{"issue":"9","key":"2608_CR5","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/0954-6111(95)90231-7","volume":"89","author":"S Charoenratanakul","year":"1995","unstructured":"Charoenratanakul S, Dejsomritrutai W, Chaiprasert A: Diagnostic role of fiberoptic bronchoscopy in suspected smear negative pulmonary tuberculosis. Respir Med. 1995, 89 (9): 621-623. 10.1016\/0954-6111(95)90231-7.","journal-title":"Respir Med"},{"issue":"1","key":"2608_CR6","first-page":"67","volume":"50","author":"A Mohan","year":"2008","unstructured":"Mohan A, Sharma SK: Fibreoptic bronchoscopy in the diagnosis of sputum smear-negative pulmonary tuberculosis: current status. Indian J Chest Dis Allied Sci. 2008, 50 (1): 67-78.","journal-title":"Indian J Chest Dis Allied Sci"},{"issue":"2","key":"2608_CR7","doi-asserted-by":"publisher","first-page":"58","DOI":"10.4103\/0970-2113.63607","volume":"27","author":"A Altaf Bachh","year":"2010","unstructured":"Altaf Bachh A, Gupta R, Haq I, Varudkar HG: Diagnosing sputum\/smear-negative pulmonary tuberculosis: Does fibre-optic bronchoscopy play a significant role?. Lung India. 2010, 27 (2): 58-62. 10.4103\/0970-2113.63607.","journal-title":"Lung India"},{"issue":"1","key":"2608_CR8","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1186\/1471-2334-12-141","volume":"12","author":"JA Shin","year":"2012","unstructured":"Shin JA, Chang YS, Kim TH, Kim HJ, Ahn CM, Byun MK: Fiberoptic bronchoscopy for the rapid diagnosis of smear-negative pulmonary tuberculosis. BMC Infect Dis. 2012, 12 (1): 141-10.1186\/1471-2334-12-141.","journal-title":"BMC Infect Dis"},{"key":"2608_CR9","volume-title":"Management of tuberculosis. A guide for low income countries","author":"DA Enarson","year":"2000","unstructured":"Enarson DA, Rieder HL, Arnadottir A, Tr\u00e9bucq A: Management of tuberculosis. A guide for low income countries. 2000, Paris: International Union Against Tuberculosis and Lung Disease, 5","edition":"5"},{"issue":"4","key":"2608_CR10","first-page":"384","volume":"9","author":"HL Rieder","year":"2005","unstructured":"Rieder HL, Chiang CY, Rusen ID: A method to determine the utility of the third diagnostic and the second follow-up sputum smear examinations to diagnose tuberculosis cases and failures. Int J Tuberc Lung Dis. 2005, 9 (4): 384-391.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"3","key":"2608_CR11","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/S0035-9203(96)90239-4","volume":"90","author":"YA Ipuge","year":"1996","unstructured":"Ipuge YA, Rieder HL, Enarson DA: The yield of acid-fast bacilli from serial smears in routine microscopy laboratories in rural Tanzania. Trans R Soc Trop Med Hyg. 1996, 90 (3): 258-261. 10.1016\/S0035-9203(96)90239-4.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2608_CR12","volume-title":"AM: Textbook of Bronchoscopy","author":"SF Feinsilver","year":"1995","unstructured":"Feinsilver SF: AM: Textbook of Bronchoscopy. 1995, Baltimore: Lippincott Williams & Wilkins, 1","edition":"1"},{"issue":"6","key":"2608_CR13","doi-asserted-by":"publisher","first-page":"969","DOI":"10.3349\/ymj.2007.48.6.969","volume":"48","author":"MH Kim","year":"2007","unstructured":"Kim MH, Suh GY, Chung MP, Kim H, Kwon OJ, Lee JH, Lee NY, Koh WJ: The value of routinely culturing for tuberculosis during bronchoscopies in an intermediate tuberculosis-burden country. Yonsei Med J. 2007, 48 (6): 969-972. 10.3349\/ymj.2007.48.6.969.","journal-title":"Yonsei Med J"},{"issue":"9","key":"2608_CR14","first-page":"855","volume":"5","author":"K Al Zahrani","year":"2001","unstructured":"Al Zahrani K, Al Jahdali H, Poirier L, Rene P, Menzies D: Yield of smear, culture and amplification tests from repeated sputum induction for the diagnosis of pulmonary tuberculosis. Int J Tuberc Lung Dis. 2001, 5 (9): 855-860.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"1","key":"2608_CR15","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1086\/599037","volume":"49","author":"F Laraque","year":"2009","unstructured":"Laraque F, Griggs A, Slopen M, Munsiff SS: Performance of nucleic acid amplification tests for diagnosis of tuberculosis in a large urban setting. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2009, 49 (1): 46-54. 10.1086\/599037.","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"2","key":"2608_CR16","first-page":"60","volume":"58","author":"G Nataraj","year":"2011","unstructured":"Nataraj G, Kanade S, Parikh R, Khatri V, Mehta P, Athavale A, Arun B: Incremental yield in sputum smear positivity by examining a second early morning sputum specimen in follow-up patients on DOTS: 7 year analysis of RNTCP laboratory register. Indian J Tuberc. 2011, 58 (2): 60-65.","journal-title":"Indian J Tuberc"},{"issue":"9004","key":"2608_CR17","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/S0140-6736(96)90915-0","volume":"347","author":"AD Harries","year":"1996","unstructured":"Harries AD, Kamenya A, Subramanyam VR, Salaniponi FM, Nyangulu DS: Sputum smears for diagnosis of smear-positive pulmonary tuberculosis. Lancet. 1996, 347 (9004): 834-835.","journal-title":"Lancet"},{"issue":"11","key":"2608_CR18","first-page":"1086","volume":"4","author":"ZL Wu","year":"2000","unstructured":"Wu ZL, Wang AQ: Diagnostic yield of repeated smear microscopy examinations among patients suspected of pulmonary TB in Shandong province of China. Int J Tuberc Lung Dis. 2000, 4 (11): 1086-1087.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"1","key":"2608_CR19","first-page":"36","volume":"4","author":"AD Harries","year":"2000","unstructured":"Harries AD, Mphasa NB, Mundy C, Banerjee A, Kwanjana JH, Salaniponi FM: Screening tuberculosis suspects using two sputum smears. Int J Tuberc Lung Dis. 2000, 4 (1): 36-40.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"6","key":"2608_CR20","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1093\/infdis\/121.6.597","volume":"121","author":"RM Schmidt","year":"1970","unstructured":"Schmidt RM, Rosenkranz HS: Antimicrobial activity of local anesthetics: lidocaine and procaine. J Infect Dis. 1970, 121 (6): 597-607. 10.1093\/infdis\/121.6.597.","journal-title":"J Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2334-13-404.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2334-13-404\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2334-13-404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2334-13-404.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T01:14:59Z","timestamp":1630545299000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/1471-2334-13-404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9,2]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["2608"],"URL":"https:\/\/doi.org\/10.1186\/1471-2334-13-404","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,9,2]]},"assertion":[{"value":"1 May 2013","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2013","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2013","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"404"}}