Objective To investigate the pathogenic bacteria culture and drug resistance of bronchoalveolar lavage fluid (BALF) in coal workers' pneumoconiosis (CWP) with lower respiratory tract infection.

Methods The patients with CWP and lower respiratory tract infection who were examined with BALF in Xinjiang Uygur Autonomous Region Occupational Disease Hospital from February 2017 to August 2019 were studied. According to the third edition of the national code of practice for clinical examination, bacterial colony count ≥ 104 CFU/mL was identified as pathogenic bacteria. The paper diffusion method and E-Test method were used for drug sensitivity test. The drug sensitivity results referred to the guidelines of CLSI 2015 and FDA standards.

Results A total of 261 strains of pathogenic bacteria were isolated from 203 samples of 314 BALF samples, and the detection rate was 64.65%. Among them, 126 were Gram-negative bacteria, accounting for 48.28%;51 were Gram-positive bacteria, accounting for 19.54%;84 were fungi, accounting for 32.18%. Klebsiella pneumoniae, pseudomonas aeruginosa and klebsiella acidogenes were resistant to cephalosporins, sulfonamides and furans, and sensitive to carbapenems. Streptococcus pneumoniae was sensitive to vancomycin and rifampicin, and resistant to compound neoforman, erythromycin, clindamycin, penicillin and tetracycline; enterococcus powdery was sensitive to linezolid and vancomycin, and resistant to erythromycin, penicillin, gentamicin, tetracycline, levofloxacin and quinupdine/daptoptin.

Conclusions BALF had a high detection rate of pathogenic bacteria. The detection rate of fungi in CWP patients with lower respiratory tract infection was high, Gram-positive bacteria and Gram-negative bacteria had serious drug resistance. The pathogenic bacteria culture of BALF had an important clinical value in guiding clinical selection of sensitive antibiotics.