BRONCHIAL
MICROBIAL PATTERNS IN CLINICALLY STABLE CHILDREN WITH BRONCHIECTASIS
Kiper N, Yalcin E, Ozcelik U, Anadol D,
Gocmen A
Hacettepe University, Ihsan Dogramaci Children’s Hospital,
Ankara,TURKEY
Objective: To determine the
frequency of microbial colonization in the lungs and the types of
responsible microorganisms, and also to compare the results of
bronchoalveolar lavage (BAL) fluid
and sputum cultures in children with stable bronchiectasis.
Methods: This study included 34
patients with a mean age of 12.5 years (male/female = 15/19) with the
clinical and radiological diagnosis of bronchiectasis which developed due
to causes other than cystic fibrosis or primary immunodeficiencies. The
patients had been free from pulmonary infections during the preceding 30
days and they had received
only supportive therapies. No patients had received antibiotic treatment
during the last 4 weeks. Sputum and BAL samples were obtained from all patients simultaneously.
Aerobic and anaerobic cultures, cultures for tuberculosis and fungi were
obtained.
Results: BAL cultures were
positive in 24 out of 34 patients (Colonization rate=70%). Sputum cultures
were positive in 7 out of 34 patients (20%). The results of sputum cultures
of 24 patients with a colonization showed no similarities with BAL fluid
cultures. The most common microorganisms identified in the cultures of BAL
samples of these 24 patients were: 15 H.
influenzae (54%), 7 S. pneumoniae
(25%).
Conclusions: Colonization of distal
airways is a frequent finding in clinically stable children with
bronchiectasis. H. influenzae was
the most common microorganism isolated. Knowing
the colonization patterns may be important for future antibiotic
prophylaxis strategies. Since sputum arises from upper respiratory tract
and oropharyngeal flora contaminates it, BAL cultures and sputum cultures
give different results. Therefore, sputum cultures do not reliably reflect
conditions in the lower airways and have limited value.