Wet cough in children: infective and inflammatory characteristics in broncho-alveolar lavage fluid

Wurzel, D. F., Marchant, J. M., Masters, I. B., Yerkovich, S. T., Upham, J. W. and Chang, A. B. (2012). Wet cough in children: infective and inflammatory characteristics in broncho-alveolar lavage fluid. In: 17th Congress of the Asian Pacific Society of Respirology, Hong Kong, (102-102). 14-16 December 2012. doi:10.1111/j.1440-1843.2012.02297.x

Author Wurzel, D. F.
Marchant, J. M.
Masters, I. B.
Yerkovich, S. T.
Upham, J. W.
Chang, A. B.
Title of paper Wet cough in children: infective and inflammatory characteristics in broncho-alveolar lavage fluid
Conference name 17th Congress of the Asian Pacific Society of Respirology
Conference location Hong Kong
Conference dates 14-16 December 2012
Journal name Respirology   Check publisher's open access policy
Place of Publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Publication Year 2012
Sub-type Published abstract
DOI 10.1111/j.1440-1843.2012.02297.x
ISSN 1323-7799
Volume 17
Issue Supp. s2
Start page 102
End page 102
Total pages 1
Language eng
Formatted Abstract/Summary
Rationale Lower airway infection has been implicated in a number of disease processes causing cough in children. Viral infection of the respiratory tract is a known risk factor for bacterial super-infection, with increasing severity of disease with viral-bacterial co-infection.
Objectives To describe the common patterns of lower airway infection in children with chronic cough and relate this to cough nature and degree of airway infl ammation.
Patients and Methods We prospectively recruited children undergoing flexible bronchoscopy and Broncho-alveolar Lavage (BAL) for a clinical indication at Royal Children’s Hospital, Brisbane. On the day of the procedure, clinical data was collected including presence, nature and duration of cough and key demographic factors. Results of microbiology, virology and cellularity of lower airway samples were collated.
Results Broncho-alveolar Lavage data was available for 232 participants. Children were divided into 3 groups for the purposes of analysis: ‘wet cough’, ‘dry cough’ and ‘no cough’. Children with wet cough were more likely to have lower airway bacterial infection (OR 2.6, p = 0.001) and viral-bacterial coinfection (OR 2.65, p = 0.042). Children with wet cough had greater lower airway inflammation than those with dry cough or no cough, with significantly higher total cell counts (p = 0.016) and % neutrophils (p < 0.0001). Viralbacterial co-infection was associated with the highest median % neutrophils across infection categories (p < 0.0001).
Conclusions Wet cough in children is associated with higher rates of lower airway infection and heightened airway neutrophilic infl ammation. Viral-bacterial co-infection is associated with the highest airway % neutrophils. Clinicians should be cognizant that children with chronic wet cough are likely to have lower airway infection.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status UQ

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