PMID- 24435356
OWN - NLM
STAT- MEDLINE
DCOM- 20141104
LR  - 20211021
IS  - 1931-3543 (Electronic)
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 145
IP  - 6
DP  - 2014 Jun
TI  - Prospective characterization of protracted bacterial bronchitis in children.
PG  - 1271-1278
LID - S0012-3692(15)34799-1 [pii]
LID - 10.1378/chest.13-2442 [doi]
AB  - BACKGROUND: Prior studies on protracted bacterial bronchitis (PBB) in children 
      have been retrospective or based on small cohorts. As PBB shares common features 
      with other pediatric conditions, further characterization is needed to improve 
      diagnostic accuracy among clinicians. In this study, we aim to further delineate 
      the clinical and laboratory features of PBB in a larger cohort, with a specific 
      focus on concurrent viral detection. METHODS: Children with and without PBB 
      (control subjects) undergoing flexible bronchoscopy were prospectively recruited. 
      Basic immune function testing and lymphocyte subset analyses were performed. BAL 
      specimens were processed for cellularity and microbiology. Viruses were 
      identified using polymerase chain reaction (PCR) and bacteria were identified via 
      culture. RESULTS: The median age of the 104 children (69% male) with PBB was 19 
      months (interquartile range [IQR], 12-30 mo). Compared with control subjects, 
      children with PBB were more likely to have attended childcare (OR, 8.43; 95% CI, 
      2.34-30.46). High rates of wheeze were present in both groups, and 
      tracheobronchomalacia was common. Children with PBB had significantly elevated 
      percentages of neutrophils in the lower airways compared with control subjects, 
      and adenovirus was more likely to be detected in BAL specimens in those with PBB 
      (OR, 6.69; 95% CI, 1.50-29.80). Median CD56 and CD16 natural killer (NK) cell 
      levels in blood were elevated for age in children with PBB (0.7 x 109/L; IQR, 
      0.5-0.9 cells/L). CONCLUSIONS: Children with PBB are, typically, very young boys 
      with prolonged wet cough and parent-reported wheeze who have attended childcare. 
      Coupled with elevated NK-cell levels, the association between adenovirus and PBB 
      suggests a likely role of viruses in PBB pathogenesis.
FAU - Wurzel, Danielle F
AU  - Wurzel DF
AD  - Queensland Children's Medical Research Institute, The University of Queensland, 
      and Queensland Children's Respiratory Centre, Royal Children's Hospital, 
      Brisbane, QLD. Electronic address: Danielle.wurzel@uqconnect.edu.au.
FAU - Marchant, Julie M
AU  - Marchant JM
AD  - Queensland Children's Medical Research Institute, The University of Queensland, 
      and Queensland Children's Respiratory Centre, Royal Children's Hospital, 
      Brisbane, QLD.
FAU - Yerkovich, Stephanie T
AU  - Yerkovich ST
AD  - School of Medicine, The University of Queensland, Brisbane, QLD; Queensland Lung 
      Transplant Service, The Prince Charles Hospital, Brisbane, QLD.
FAU - Upham, John W
AU  - Upham JW
AD  - School of Medicine, The University of Queensland, Brisbane, QLD; Department of 
      Respiratory Medicine, Princess Alexandra Hospital, Brisbane, QLD.
FAU - Mackay, Ian M
AU  - Mackay IM
AD  - Queensland Paediatric, Infectious Diseases Laboratory, Queensland Children's 
      Medical Research Institute, Sir Albert, Sakzewski Virus Research Centre, 
      Children's Health Queensland Hospital and Health Service, The University of 
      Queensland, Herston, QLD.
FAU - Masters, I Brent
AU  - Masters IB
AD  - Queensland Children's Medical Research Institute, The University of Queensland, 
      and Queensland Children's Respiratory Centre, Royal Children's Hospital, 
      Brisbane, QLD.
FAU - Chang, Anne B
AU  - Chang AB
AD  - Queensland Children's Medical Research Institute, The University of Queensland, 
      and Queensland Children's Respiratory Centre, Royal Children's Hospital, 
      Brisbane, QLD; Child Health Division, Menzies School of Health Research, Charles 
      Darwin University, Darwin, NT, Australia.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
SB  - IM
MH  - Adenoviridae/isolation & purification
MH  - Adenoviridae Infections/diagnosis/epidemiology
MH  - Bacterial Infections/*diagnosis/epidemiology/*pathology
MH  - Bronchitis/*diagnosis/*microbiology/pathology
MH  - Bronchoalveolar Lavage Fluid/virology
MH  - Case-Control Studies
MH  - Cell Count
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Comorbidity
MH  - Cough/diagnosis/epidemiology
MH  - Female
MH  - Humans
MH  - Immune System/*physiopathology
MH  - Infant
MH  - Killer Cells, Natural/pathology
MH  - Lymphocyte Subsets/*pathology
MH  - Male
MH  - Neutrophils/pathology
MH  - Prospective Studies
MH  - Sex Factors
PMC - PMC7173205
EDAT- 2014/01/18 06:00
MHDA- 2014/11/05 06:00
PMCR- 2015/12/30
CRDT- 2014/01/18 06:00
PHST- 2014/01/18 06:00 [entrez]
PHST- 2014/01/18 06:00 [pubmed]
PHST- 2014/11/05 06:00 [medline]
PHST- 2015/12/30 00:00 [pmc-release]
AID - S0012-3692(15)34799-1 [pii]
AID - 10.1378/chest.13-2442 [doi]
PST - ppublish
SO  - Chest. 2014 Jun;145(6):1271-1278. doi: 10.1378/chest.13-2442.