Lung Cancer and bronchial infection

Infectious diseases are one of the leading causes of death (35-70%) in lung cancer patients. We assessed the relationship between lung cancer and infection of the bronchial tree by broncho lavage using fibrobronchoscopy (FBS); among patients with lung cancer and pulmonary infection (A: n=29), patients with lung cancer (B n=85) and patients with pulmonary infections only (C: n=16). 183 patients undergoing diagnostic FBS with sampling for microbiological examination by bronchial lavage and for cytology/histology by biopsy, brushing or needle aspiration was enrolled. Pathogenic microorganisms were isolated in 25.4% of neoplastic patients. There was a statistically significant increase (p 0.028) of the white blood cells in the group A than in B. In group A the most frequent pathogen was the Aspergillus (18.9%) with a statistically significant prevalence compared to group C (0%) (p = 0.035). In group C the most frequent isolated pathogens were Escherichia coli (16.6%). Undifferentiated carcinoma was the histological type with a higher proportion of infections (40%). In group A the most commonly affected lobe was the right upper (37.8%), followed by the left upper (18,9%). The most frequently germ found in hospitalized cancer patients (15 pts) was the Aspergillus (29.4%) while Escherichia coli (20%) was more frequent in not hospitalized patients (14 pts). Aspergillus (21.7%) was the most frequent microorganism in patients with central lesions (16 pts) whereas Candida (21.4%) in peripheral lesions (13 pts) (p 0.046). Our results strongly suggest that microbiological assessment of bronchial sampling in lung cancer patients is required to identify more robust and specific antimicrobial therapy to prevent lung infection complications.