Comparison of bronchoscopy and bronchoalveolar lavage findings in three types of suppurative lung disease

Jorrit J.V. de Vries, Anne B. Chang, Julie M. Marchant

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Endobronchial suppuration is present in children with protracted bacterial bronchitis (PBB), bronchiectasis, and cystic fibrosis (CF). However, no studies have directly compared bronchoscopy and bronchoalveolar lavage (BAL) findings across these conditions within a single center using the same techniques and with shared community pathogens.

    Aim: To determine; (i) the bronchoscopic findings and BAL microbiology and cellularity among children with these conditions and; (ii) the relationship between bacterial pathogens, airway cellularity and aberrant macroscopic bronchoscopic findings. Methods: We retrospectively reviewed all bronchoscopy data (undertaken over 6.5-years) from our center in children (<6 years; n = 316) meeting definitions of PBB (n = 125), bronchiectasis (n = 138), and CF (n = 53).

    Results: The children's median age was 26-months (Interquartile range (IQR) = 16-43). Children with PBB and bronchiectasis had higher rates of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae infection, whereas children with CF had frequent Pseudomonas aeruginosa and Staphylococcus aureus infections. Novel findings include detection of cytomegalovirus and Epstein-Barr virus (EBV) (by polymerase chain reaction) in children with PBB (26%, 17%, respectively) and bronchiectasis (27%, 29%). Median airway neutrophil percentage was significantly higher in CF (68%; IQR = 42-83) compared to PBB (36%; IQR = 18-68) and bronchiectasis (22%; IQR = 8-64) (P < 0.0001), despite lower rates of infection. Presence of malacia did not significantly impact on infection or inflammation.

    Conclusion: In this first study to directly compare bronchoscopic data among young children with PBB, bronchiectasis, and CF, microbiological patterns of airway infections and neutrophilia varied. Our findings of cytomegalovirus and EBV detection in children with PBB and bronchiectasis require confirmation and further evaluation.

    Original languageEnglish
    Pages (from-to)467-474
    Number of pages8
    JournalPediatric Pulmonology
    Volume53
    Issue number4
    Early online date6 Feb 2018
    DOIs
    Publication statusPublished - 1 Apr 2018

    Fingerprint

    Bronchoscopy
    Bronchoalveolar Lavage
    Bronchiectasis
    Lung Diseases
    Bronchitis
    Cystic Fibrosis
    Infection
    Cytomegalovirus
    Human Herpesvirus 4
    Pneumococcal Infections
    Moraxella (Branhamella) catarrhalis
    Suppuration
    Haemophilus influenzae
    Microbiology
    Pseudomonas aeruginosa
    Staphylococcus aureus
    Neutrophils
    Inflammation
    Polymerase Chain Reaction

    Cite this

    @article{327f3c98149f4dbfb05e9caa23501672,
    title = "Comparison of bronchoscopy and bronchoalveolar lavage findings in three types of suppurative lung disease",
    abstract = "Background: Endobronchial suppuration is present in children with protracted bacterial bronchitis (PBB), bronchiectasis, and cystic fibrosis (CF). However, no studies have directly compared bronchoscopy and bronchoalveolar lavage (BAL) findings across these conditions within a single center using the same techniques and with shared community pathogens. Aim: To determine; (i) the bronchoscopic findings and BAL microbiology and cellularity among children with these conditions and; (ii) the relationship between bacterial pathogens, airway cellularity and aberrant macroscopic bronchoscopic findings. Methods: We retrospectively reviewed all bronchoscopy data (undertaken over 6.5-years) from our center in children (<6 years; n = 316) meeting definitions of PBB (n = 125), bronchiectasis (n = 138), and CF (n = 53). Results: The children's median age was 26-months (Interquartile range (IQR) = 16-43). Children with PBB and bronchiectasis had higher rates of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae infection, whereas children with CF had frequent Pseudomonas aeruginosa and Staphylococcus aureus infections. Novel findings include detection of cytomegalovirus and Epstein-Barr virus (EBV) (by polymerase chain reaction) in children with PBB (26{\%}, 17{\%}, respectively) and bronchiectasis (27{\%}, 29{\%}). Median airway neutrophil percentage was significantly higher in CF (68{\%}; IQR = 42-83) compared to PBB (36{\%}; IQR = 18-68) and bronchiectasis (22{\%}; IQR = 8-64) (P < 0.0001), despite lower rates of infection. Presence of malacia did not significantly impact on infection or inflammation. Conclusion: In this first study to directly compare bronchoscopic data among young children with PBB, bronchiectasis, and CF, microbiological patterns of airway infections and neutrophilia varied. Our findings of cytomegalovirus and EBV detection in children with PBB and bronchiectasis require confirmation and further evaluation.",
    keywords = "airway microbiology, bronchiectasis, bronchoalveolar lavage (BAL), children, cystic fibrosis (CF), protracted bacterial bronchitis (PBB)",
    author = "{de Vries}, {Jorrit J.V.} and Chang, {Anne B.} and Marchant, {Julie M.}",
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    }

    Comparison of bronchoscopy and bronchoalveolar lavage findings in three types of suppurative lung disease. / de Vries, Jorrit J.V.; Chang, Anne B.; Marchant, Julie M.

    In: Pediatric Pulmonology, Vol. 53, No. 4, 01.04.2018, p. 467-474.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Comparison of bronchoscopy and bronchoalveolar lavage findings in three types of suppurative lung disease

    AU - de Vries, Jorrit J.V.

    AU - Chang, Anne B.

    AU - Marchant, Julie M.

    PY - 2018/4/1

    Y1 - 2018/4/1

    N2 - Background: Endobronchial suppuration is present in children with protracted bacterial bronchitis (PBB), bronchiectasis, and cystic fibrosis (CF). However, no studies have directly compared bronchoscopy and bronchoalveolar lavage (BAL) findings across these conditions within a single center using the same techniques and with shared community pathogens. Aim: To determine; (i) the bronchoscopic findings and BAL microbiology and cellularity among children with these conditions and; (ii) the relationship between bacterial pathogens, airway cellularity and aberrant macroscopic bronchoscopic findings. Methods: We retrospectively reviewed all bronchoscopy data (undertaken over 6.5-years) from our center in children (<6 years; n = 316) meeting definitions of PBB (n = 125), bronchiectasis (n = 138), and CF (n = 53). Results: The children's median age was 26-months (Interquartile range (IQR) = 16-43). Children with PBB and bronchiectasis had higher rates of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae infection, whereas children with CF had frequent Pseudomonas aeruginosa and Staphylococcus aureus infections. Novel findings include detection of cytomegalovirus and Epstein-Barr virus (EBV) (by polymerase chain reaction) in children with PBB (26%, 17%, respectively) and bronchiectasis (27%, 29%). Median airway neutrophil percentage was significantly higher in CF (68%; IQR = 42-83) compared to PBB (36%; IQR = 18-68) and bronchiectasis (22%; IQR = 8-64) (P < 0.0001), despite lower rates of infection. Presence of malacia did not significantly impact on infection or inflammation. Conclusion: In this first study to directly compare bronchoscopic data among young children with PBB, bronchiectasis, and CF, microbiological patterns of airway infections and neutrophilia varied. Our findings of cytomegalovirus and EBV detection in children with PBB and bronchiectasis require confirmation and further evaluation.

    AB - Background: Endobronchial suppuration is present in children with protracted bacterial bronchitis (PBB), bronchiectasis, and cystic fibrosis (CF). However, no studies have directly compared bronchoscopy and bronchoalveolar lavage (BAL) findings across these conditions within a single center using the same techniques and with shared community pathogens. Aim: To determine; (i) the bronchoscopic findings and BAL microbiology and cellularity among children with these conditions and; (ii) the relationship between bacterial pathogens, airway cellularity and aberrant macroscopic bronchoscopic findings. Methods: We retrospectively reviewed all bronchoscopy data (undertaken over 6.5-years) from our center in children (<6 years; n = 316) meeting definitions of PBB (n = 125), bronchiectasis (n = 138), and CF (n = 53). Results: The children's median age was 26-months (Interquartile range (IQR) = 16-43). Children with PBB and bronchiectasis had higher rates of Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae infection, whereas children with CF had frequent Pseudomonas aeruginosa and Staphylococcus aureus infections. Novel findings include detection of cytomegalovirus and Epstein-Barr virus (EBV) (by polymerase chain reaction) in children with PBB (26%, 17%, respectively) and bronchiectasis (27%, 29%). Median airway neutrophil percentage was significantly higher in CF (68%; IQR = 42-83) compared to PBB (36%; IQR = 18-68) and bronchiectasis (22%; IQR = 8-64) (P < 0.0001), despite lower rates of infection. Presence of malacia did not significantly impact on infection or inflammation. Conclusion: In this first study to directly compare bronchoscopic data among young children with PBB, bronchiectasis, and CF, microbiological patterns of airway infections and neutrophilia varied. Our findings of cytomegalovirus and EBV detection in children with PBB and bronchiectasis require confirmation and further evaluation.

    KW - airway microbiology

    KW - bronchiectasis

    KW - bronchoalveolar lavage (BAL)

    KW - children

    KW - cystic fibrosis (CF)

    KW - protracted bacterial bronchitis (PBB)

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    U2 - 10.1002/ppul.23952

    DO - 10.1002/ppul.23952

    M3 - Article

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    JO - Pediatric Pulmonology

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    SN - 1099-0496

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