Bronchoalveolar lavage fluid microbiology and airway cellularity in children with newly diagnosed bronchiectasis

Kapur, N., Grimwood, K., Masters, B., Morris, P. and Chang, A. (2010). Bronchoalveolar lavage fluid microbiology and airway cellularity in children with newly diagnosed bronchiectasis. In: 15th Congress of the Asian Pacific Society of Respirology, Manila, Philippines, (29-29). 22-25 November 2010.

Author Kapur, N.
Grimwood, K.
Masters, B.
Morris, P.
Chang, A.
Title of paper Bronchoalveolar lavage fluid microbiology and airway cellularity in children with newly diagnosed bronchiectasis
Conference name 15th Congress of the Asian Pacific Society of Respirology
Conference location Manila, Philippines
Conference dates 22-25 November 2010
Journal name Respirology   Check publisher's open access policy
Publisher Wiley-Blackwell
Publication Year 2010
Sub-type Published abstract
ISSN 1323-7799
1440-1843
Volume 15
Issue s2
Start page 29
End page 29
Total pages 1
Language eng
Formatted Abstract/Summary
Introduction: Despite the importance of infection and infl ammation in the
pathogenesis and management of bronchiectasis, there are few published
data on lower airway microbiology and cellularity in these children.
Methods: Children attending a single centre (1992 to 2009) with non-cystic
fi brosis bronchiectasis who underwent bronchoalveolar lavage (BAL) within 4
weeks of diagnosis were identifi ed. The point prevalence of infection (>105
colony-forming units (CFU)/mL of respiratory bacterial pathogens), its effects
upon airway cellularity and the impact of clinical and demographic variables
on infection risk were evaluated.
Results: Of 113 children with bronchiectasis, 44 (39%) had BAL evidence
(>105 CFU/mL) of infection, which was frequently polymicrobial and caused
mostly by Haemophilus infl uenzae, Streptococcus pneumoniae and Moraxella
catarrhalis. In contrast, Pseudomonas aeruginosa was uncommon and mycobacterial
and fungal species were undetected. Upper airway commensal
organisms were also isolated in large numbers (>105 CFU/mL) from 24 (21%)
BAL cultures. The median (interquartile range; IQR) BAL fl uid total cell counts
(TCC × 106/L) and neutrophil percentages were signifi cantly higher in those
with, than without, infection [TCC 730 (320–4140) vs 280 (143–1131); P =
0.001 and neutrophil percentage 76% (22–94) vs 38% (12–80); P = 0.01
respectively]. Only age at diagnosis was associated with infection.
Conclusion: BAL microbiology of children with newly diagnosed bronchiectasis
substantially differs from adults. Children have marked airway neutrophilia,
particularly when bacterial loads were high. Younger children were more
likely to have a lower airway infection at diagnosis. The role and interactions
of respiratory bacterial fl ora in initiating and progressing airway damage in
bronchiectasis requires further study.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
Google Scholar Search Google Scholar
Created: Sat, 22 Oct 2011, 06:27:41 EST by System User on behalf of Child Health Research Centre