Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis

Kapur, Nitin, Grimwood, Keith, Masters, I. Brent, Morris, Peter S. and Chang, Anne B. (2012) Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis. Pediatric Pulmonology, 47 3: 300-307. doi:10.1002/ppul.21550

Author Kapur, Nitin
Grimwood, Keith
Masters, I. Brent
Morris, Peter S.
Chang, Anne B.
Title Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 8755-6863
Publication date 2012-03
Year available 2011
Sub-type Article (original research)
DOI 10.1002/ppul.21550
Volume 47
Issue 3
Start page 300
End page 307
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Collection year 2012
Language eng
Formatted abstract
Infection and inflammation are important in the pathogenesis of bronchiectasis. However, there are few published data describing the lower airway microbiology and cellularity in children.


Children with non-cystic fibrosis (CF) bronchiectasis who underwent bronchoalveolar lavage (BAL) within 4 weeks of diagnosis were identified by a retrospective patient-record review. The effects of infection (≥105 colony-forming units of respiratory bacteria/ml; or detectable Pseudomonas aeruginosa; mycobacteria, fungi, mycoplasma, or respiratory viruses) on airway cellularity and the impact of age, gender, indigenous status, immune function, radiographic involvement and antibiotic usage on infection risk were evaluated.


Of 113 children [median age 63 months (IQR 32–95)] with newly diagnosed bronchiectasis, 77 (68%) had positive BAL cultures for respiratory bacterial pathogens. Haemophilus influenzae was most commonly detected, being present in 53 (47%) BAL specimens. P. aeruginosa was found in just 7 (6%) children, five of whom had an underlying disorder, while mycobacterial and fungal species were not detected. Respiratory viruses were identified in 14 (12%) children and Mycoplasma pneumoniae in two others. Overall, 56 (49.5%) children fulfilled our definition of a lower airway infection and of these, 35 (63%) had more than one pathogen present. Compared to children without infection, children with infection had higher total cell counts (610 vs. 280 × 106/L), neutrophil counts (351 vs. 70 × 106/L), and neutrophil percentages (69% vs. 34%). Age at diagnosis was most strongly associated with infection.

BAL microbiology of children with newly diagnosed bronchiectasis is dominated by H. influenzae. In the absence of CF, isolation of P. aeruginosa may suggest a serious co-morbidity in this group. Airway neutrophilia is common, especially with higher bacterial loads.
Keyword Airway cellularity
Bronchoalveolar lavage
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Presented at the 15th Congress of the Asia Pacific Society of Respirology, Manila, Philippines, 2010 and at the Annual Scientific Meeting of the Thoracic Society of Australia and New Zealand, Perth, Australia, 2011. ; Early View (Online Version of Record published before inclusion in an issue) Published online 7 September 2011.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Faculty of Health and Behavioural Sciences -- Publications
Official 2012 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 28 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 28 times in Scopus Article | Citations
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Created: Mon, 19 Dec 2011, 13:14:02 EST by Jane Medhurst on behalf of Child Health Research Centre