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

Kim Hare, K Grimwood, Amanda Leach, H Smith-Vaughan, Paul Torzillo, Peter Morris, AB Chang

    Research output: Contribution to journalArticlepeer-review

    80 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)1001-1005
    Number of pages5
    JournalJournal of Pediatrics
    Volume157
    Issue number6
    DOIs
    Publication statusPublished - Dec 2010

    Keywords

    • BAL
    • Bronchoalveolar lavage
    • CF
    • CFU
    • Chest high-resolution computed tomography
    • CHRCT
    • CI
    • Colony-forming unit
    • Confidence interval
    • Cystic fibrosis
    • Nasopharyngeal
    • Negative predictive value
    • Nontypable Haemophilus influenzae
    • NP
    • NPV
    • NTHi
    • OP
    • Oropharyngeal
    • PCR

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