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- Title
Bacteria from bronchoalveolar lavage fluid from children with suspected chronic lower respiratory tract infection: results from a multi-center, cross-sectional study in Spain.
- Authors
Escribano Montaner, Amparo; García de Lomas, Juan; Villa Asensi, José Ramón; Asensio de la Cruz, Oscar; de la Serna Blázquez, Olga; Santiago Burruchaga, Mikel; Mondéjar López, Pedro; Torrent Vernetta, Alba; Feng, Yang; Van Dyke, Melissa K.; Reyes, Janet; Garcia-Corbeira, Pilar; Talarico, Carla A.; on behalf of the EPI-Strep-064 study group; EPI-Strep-064 study group
- Abstract
This cross-sectional study assessed the prevalence of bacteria isolated from Spanish children with suspected chronic lower respiratory tract infection (LRTI) for whom bronchoalveolar lavage (BAL) was indicated. BAL fluid (BALF) was collected from 191 children (aged ≥ 6 months to < 6 years, with persistent or recurrent respiratory symptoms, non-responders to usual treatment) and cultured. Nasopharyngeal swabs (NPSs) were also obtained and cultured to assess concordance of BALF and NPS findings in the same patient. Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis were identified from BALF with a bacterial load indicative of infection (> 104 colony-forming units/mL) in 10.5, 8.9, and 6.3% of children, respectively. Clinical characteristics were similar among participants, regardless of positivity status for any of the bacteria. Approximately 26% of pneumococcal isolates were PCV13 serotypes, and 96% of H. influenzae isolates were non-typeable (NTHi). Concordance between BALF and NPS isolates was 51.0% for S. pneumoniae, 52.1% for H. influenzae, and 22.0% for M. catarrhalis.<bold>Conclusion: </bold>S. pneumoniae, NTHi, and M. catarrhalis were the main bacteria detected in BALF and NPS. Children with suspected chronic LRTI may benefit from a vaccine protecting against NTHi. What is Known: • Chronic lower respiratory tract infection (LRTI) in children can cause high morbidity and is a major use of healthcare resources worldwide. Despite this, their etiology or potential preventive measures are poorly assessed. • Bronchoalveolar lavage can be used to determine bacterial etiology of chronic LRTI. What is New: • We used conventional and molecular techniques to show that Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis were present in the LRT of Spanish children with suspected chronic LRTI • Concordance between isolates from bronchoalveolar lavage fluid and nasopharyngeal swabs was low, suggesting that samples from the upper respiratory tract could not reliably predict the bacterial etiology of suspected chronic LRTI.
- Subjects
SPAIN; RESPIRATORY infections in children; BRONCHOALVEOLAR lavage; STREPTOCOCCUS pneumoniae; HAEMOPHILUS influenzae; RESPIRATORY organ microbiology; CHILDREN; DIAGNOSIS of bacterial diseases; PNEUMONIA diagnosis; STREPTOCOCCAL disease diagnosis; BACTERIAL diseases; BODY fluids; CHRONIC diseases; CLINICAL trials; COMPARATIVE studies; HAEMOPHILUS diseases; RESEARCH methodology; MEDICAL cooperation; PNEUMONIA; PSEUDOMONADALES; RESEARCH; STREPTOCOCCAL diseases; EVALUATION research; CROSS-sectional method; GRAM-negative aerobic bacteria; DIAGNOSIS
- Publication
European Journal of Pediatrics, 2018, Vol 177, Issue 2, p181
- ISSN
0340-6199
- Publication type
journal article
- DOI
10.1007/s00431-017-3044-3