Prospective characterization of protracted bacterial bronchitis in children

Wurzel, D.F., Marchant, J.M., Yerkovich, S.T., Upham, J.W., Mackay, I.M., Masters, I.B. and Chang, A.B. (2014) Prospective characterization of protracted bacterial bronchitis in children. Chest, 145 6: 1271-1278. doi:10.1378/chest.13-2442

Author Wurzel, D.F.
Marchant, J.M.
Yerkovich, S.T.
Upham, J.W.
Mackay, I.M.
Masters, I.B.
Chang, A.B.
Title Prospective characterization of protracted bacterial bronchitis in children
Journal name Chest   Check publisher's open access policy
ISSN 1931-3543
Publication date 2014-06-01
Year available 2014
Sub-type Article (original research)
DOI 10.1378/chest.13-2442
Open Access Status Not yet assessed
Volume 145
Issue 6
Start page 1271
End page 1278
Total pages 8
Place of publication GLENVIEW
Publisher American College of Chest Physicians
Language eng
Subject 2740 Pulmonary and Respiratory Medicine
2706 Critical Care and Intensive Care Medicine
2705 Cardiology and Cardiovascular Medicine
Abstract Background: Prior studies on protracted bacterial bronchitis (PBB) in children have been retrospective or based on small cohorts. As PBB shares common features with other pediatric conditions, further characterization is needed to improve diagnostic accuracy among clinicians. In this study, we aim to further delineate the clinical and laboratory features of PBB in a larger cohort, with a specific focus on concurrent viral detection. Methods: Children with and without PBB (control subjects) undergoing flexible bronchoscopy were prospectively recruited. Basic immune function testing and lymphocyte subset analyses were performed. BAL specimens were processed for cellularity and microbiology. Viruses were identified using polymerase chain reaction (PCR) and bacteria were identified via culture. Results: The median age of the 104 children (69% male) with PBB was 19 months (interquartile range [IQR], 12-30 mo). Compared with control subjects, children with PBB were more likely to have attended childcare (OR, 8.43; 95% CI, 2.34-30.46). High rates of wheeze were present in both groups, and tracheobronchomalacia was common. Children with PBB had significantly elevated percentages of neutrophils in the lower airways compared with control subjects, and adenovirus was more likely to be detected in BAL specimens in those with PBB (OR, 6.69; 95% CI, 1.50-29.80). Median CD56 and CD16 natural killer (NK) cell levels in blood were elevated for age in children with PBB (0.7 × 109/L; IQR, 0.5-0.9 cells/L). Conclusions: Children with PBB are, typically, very young boys with prolonged wet cough and parent-reported wheeze who have attended childcare. Coupled with elevated NK-cell levels, the association between adenovirus and PBB suggests a likely role of viruses in PBB pathogenesis.
Keyword Critical Care Medicine
Respiratory System
General & Internal Medicine
Respiratory System
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 1042601
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
Queensland Children's Medical Research Institute Publications
School of Medicine Publications
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