Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

All Conditions

Infections

Symptoms and General Pathology

Lung Neoplasms

Communicable Diseases

Disease Attributes

Anti-Arrhythmia Agents

Channel Blockers

Central Nervous System Depressants

All Drugs and Chemicals

Pharmaceutical Solutions

Adjuvants, Anesthesia

Psychotropic Drugs

Lidocaine

Midazolam

* 2%lidocaine gel will be used to anaesthesize nasal mucosa.6ml lidocaine 2%diluted in 5cc normal saline lidocaine spray solution will be used for anaesthesizing the vocal cords and mucosa of the bronchial tree(13).
* Intravenous midazolam (0.01-0.1mg\\kg) will be given to achieve conscious sedation in selected cases(13).
* Flexible Bronchoscopy will be done under continuous monitoring for O2 saturation, heart rate, blood pressure and respiratory rate.
* The bronchoscope will be introduced into the nasal cavity and advanced to the level of the vocal cords. Lidocaine will be instilled through the bronchoscope to the vocal cords and tracheobronchial tree.
* Using sterile bronchoscope in the lobar bronchus of tumor location,100 mL of sterile normal saline in fractionated doses will be injected and then BAL will be removed by suction to be collected in sterile side-way bottles.

bronchoscopy brochoalveolar lavage

Tasneem H Younes, resident

Olfat M Elshenawy, professor

Mohamed M Abdelhady, professor

Hebatallah G Rashed, professor

Mohamed M Abdelhadi, professor

Primary Aim:

-To determine the prevalence and pattern of bronchial colonization in patients presenting with lung cancer at the time of diagnosis

Secondary Aim:

-To assess the potential demographic, clinical, radiological and histological predictors of colonization in patients with lung cancer

Lung cancer is the world's most common neoplasm and its incidence is rising. Lung cancer has the highest mortality rates of all cancers. Pulmonary infections, especially pneumonia, frequently complicate the course of lung cancer and are often the ultimate cause of death.

It has been suggested that bronchial colonization plays a key role in the establishment of pulmonary infections in patients with lung cancer, and thus clearly influences the therapeutic management and probably the prognosis of cancer.

In such patients, colonization may arise following local bronchial impairment, e.g. stenosis or impaired mucociliary clearance, or be caused by more general abnormalities, including immunosuppression, malnutrition, smoking, chronic obstructive pulmonary disease (COPD) and chemotherapy. Studies indicate that bronchial colonization can be demonstrated in 48.1% of patients with lung cancer and may be caused by potential pathogenic microorganisms (PPMs), mainly Haemophilus influenzae, Streptococcus pneumoniae and Staphylococcus aureus. Other potential microbial agents, such as mycobacteria and fungi, have not been investigated systematically However, there is a wide variation in the microbial profile reported from the previous studies; some of which reporting predominance of Gram-positive organisms- streptococcus pneumoniae in particular, while more recent studies reported predominance of Gram-negative organisms, which may indicate a shift in the spectrum of organism colonizing bronchial tree of lung cancer patients in parallel to the increased trends of antibiotic exposures, something this study will re-examine. Moreover, given the paucity of literature highlighting the potential predictors of colonization in such patients, overlooking data on radiological findings in lung cancer patients and underreporting the impact of comorbidities, this study aims to further explore a wider array of potential demographic, clinical, radiological and histological determinants.

* Bronchial wash and BAL will be processed within 2 h for bacterial, mycobacterial and mycological analysis using routine procedures. Specimens will be mixed and cultured on blood agar, chocolate agar, Sabarauds' Dextrose agar, MacConkey agar and Lowenstein Jensen medium.
* Blood sample will be collected aseptically inoculated into the blood culture bottles, A blood culture system (BACT/ALERT 3D, BioMérieux Inc., Durham,USA) will be used for incubating blood culture samples and will be evaluated for 7 days. Positive blood culture bottles will be subjected to Gram's staining, cultured on blood agar, chocolate agar, Sabarauds' Dextrose agar and MacConkey agar.

Bronchoscopic and blood culture samples that are positive for bacterial growth will undergo antimicrobial drug sensitivity testing .

Microbial Colonization in Lung Cancer Patients

Colonization will be defined as isolation of microorganisms from bronchoscopic wash samples at a threshold of 102 cfu.mL-1, whereas infection will be considered at .105 cfu.mL-1 . Regardless of the amount, isolation of mycobacteria and non-commensal fungi will be considered as colonization or an infection depending on the species isolated.

Demographic, clinical, radiological and histological data will be examined using univariate and multivariate regression analysis to identify their potential predictability of the colonization in patients with lung cancer.

Assiut University

Resident in chest department of assiut university hospital

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Microbial Colonization in Lung Cancer Patients	NCT05748795	Microbial Colon...	bronchoscopy br...	18 Years -	Assiut University
Microbial Colonization in Lung Cancer Patients	NCT05748795	Microbial Colon...	bronchoscopy br...	18 Years -	Assiut University

Spots Global Cancer Trial Database for bronchoscopy brochoalveolar lavage