Table 1 . Results of the Conventional Technique and the Dip Slide Method in Patients With Clinically

Background: Quantitative bacteriologic workup of BAL fluid (BALF) has evolved as a sensitive and specific technique for the diagnosis of bacterial pneumonia. Conventional quantitative cultures are expensive, time-consuming, and often unavailable on a 24-h basis. Therefore, we evaluated a dip slide method for the semiquantitative measurement of bacterial cultures in BALF specimens and com¬ pared the results with those from conventional quantitative cultures. Methods: Fifty BALF specimens from 45 patients with suspected pulmonary infection were exam¬ ined prospectively with both methods. We compared the microbiologic results of conventional quantitative cultures with those of the dip slide method that is commercially available for blood cultures. Cost-effectiveness analysis of both methods was performed. Results: In 37BALF specimens, 64 bacterial strains were detected with both techniques. The dip slide method and conventional cultures showed a high correlation with respect to the colony counts of the individual organisms per milliliter BALF (r=0.935; p= 0.0001) and the sum of colony counts in individual patients (r=0.947; p=0.0001). Although five strains were not detected by the dip slide technique, the diagnostic accuracy was not influenced. In 13 BALF samples, there was no growth ofbacteria with both techniques. While the diagnostic yield ofboth methods was similar, the dip slide technique was 44 to 66% less expensive than conventional cultures. Conclusions: The examination ofBALF with a dip slide method is highly comparable to conventional quantitative culture techniques, less expensive, and can be used independently of a specialized mi¬ crobiology laboratory on a 24-hbasis. (CHEST 1996; 109:1423-29)