Abstract
Background: The role of bacteria has usually been underestimated in children with chronic respiratory symptoms.
Aims: To describe the incidence of positive (+) bacterial cultures (BC) in bronchoalveolar lavage (BAL) fluid in children with chronic symptoms, and to assess differences between children with and without bronchiectasis (BCE).
Methods: We carried out a review of all BAL performed from 2007 to 2010 in outpatients of our respiratory clinic. We defined 2 groups (gr): 1) BCE of unknown etiology; 2) Other chronic respiratory conditions. Patients with cystic fibrosis or receiving antibiotic treatment at the moment of the BAL were excluded. Chi2 test was used to assess differences between both gr and the association between gr 1 and the presence of purulent airway (AW) secretions. A multivariate logistic regression was built using gr as dependent variable; and gender, age, AW malacia and gastroesophageal reflux (GER) as independent ones.
Results: The final sample consisted of 70 children (56% male; gr 1: 23, gr 2: 47) who underwent a BAL at a median age 51.7±35 mo. BC was + in 48 (69%) children: 19 (83%) in gr 1 and 29 (62%) in gr 2 (p=0.077). Among + BC, the most common bacteria were H influenzae (n=26) and S pneumoniae (n=18), followed by S aureus (n=5), P aeruginosa (n=4) and K pneumoniae (n=2). A very significant association was found between gr 1 and purulent secretions (p<0.0001).
Conclusion: Although a + BC in BAL fluid is more common in children with BCE, the role of bacteria in other non-suppurative lung diseases should be taken into account.
- © 2011 ERS