Respiratory Bacterial Pathogens in the Nasopharynx and Lower Airways of Australian Indigenous Children with Bronchiectasis

Objective To test the hypothesis that bacterial density, strain diversity, and concordance of pathogens between upper and lower airways are higher in children with bronchiectasis than in those with non-bronchiectatic conditions. Study design Nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL)...

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Published in:	The Journal of pediatrics 2010-12, Vol.157 (6), p.1001-1005
Main Authors:	Hare, Kim M., MPH, Grimwood, Keith, MD, FRACP, Leach, Amanda J., PhD, Smith-Vaughan, Heidi, PhD, Torzillo, Paul J., MBBS, FRACP, Morris, Peter S., PhD, FRACP, Chang, Anne B., PhD, FRACP
Format:	Article
Language:	eng
Subjects:	Alveoli Australia Bacteria Biological and medical sciences Bronchiectasis Bronchiectasis - microbiology Bronchus Child Child, Preschool Children Female General aspects Genotypes Haemophilus influenzae Haemophilus influenzae - isolation & purification Humans Infant Male Medical sciences Moraxella (Branhamella) catarrhalis - isolation & purification Moraxella catarrhalis Nasopharynx Nasopharynx - microbiology Oceanic Ancestry Group Pathogens Pediatrics Pneumology Respiratory system : syndromes and miscellaneous diseases Respiratory tract Secretions Streptococcus pneumoniae Streptococcus pneumoniae - isolation & purification
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Summary:	Objective To test the hypothesis that bacterial density, strain diversity, and concordance of pathogens between upper and lower airways are higher in children with bronchiectasis than in those with non-bronchiectatic conditions. Study design Nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluid were cultured from 45 Indigenous children with bronchiectasis and 30 non-Indigenous children with non-bronchiectatic respiratory symptoms. Lower airway infection was defined as >104 colony-forming units of respiratory bacteria/mL of BAL fluid. Concordance was determined by phenotype or genotype. Results NP carriage of Streptococcus pneumoniae , nontypable Haemophilus influenzae (NTHi), and Moraxella catarrhalis , and lower airway infection by NTHi (47% vs 3%), were detected significantly more often in the children with bronchiectasis than in those without this condition. BAL specimens from the infected Indigenous children also showed greater strain diversity (71% vs 0%). Strain concordance in NP and BAL cultures was high in both infected subgroups. Conclusions The high density and diversity of respiratory bacteria, along with strain concordance between upper and lower airways, found in Indigenous children with bronchiectasis suggest a possible pathogenic role of recurrent aspiration of NP secretions.
ISSN:	0022-3476 1097-6833