Source: Annual Congress 2006 - Pneumonia and other invasive pulmonary infections in children
Disease area: Respiratory infections

Abstract

Chronic obstructive airway disease in children is commonly investigated by bronchoscopy, if unresponsive to treatment, in order to exclude anatomical or functional narrowing of the airways. The usefulness of BAL fluid for respiratory pathogens by PCR testing has not been studied in this group so far.
Methods: We prospectively analysed the BAL fluid of 98 children at a mean age of 2.8 y with chronic obstructive airway disease (mean duration of symptoms 4.6 mo) unresponsive to anti-asthmatic treatment including inhaled steroids, using a 9- and 19-valent multiplex RT-PCR, respectively, for common respiratory viruses and Mycoplasma, Chlamydia pneumoniae, Bordetella pertussis and parapertussis, Legionella pneumophila as well as CMV and EBV by mono-PCRs.
Results: PCR was found positive in 47 of 98 patients (48%) with the following frequency: CMV 10, Adeno-V 10, Rhino-V 9, Entero-V 8, Parainfluenza-V I-III 6, EBV 4, Influenza-V 3, Mycoplasma 2, RSV 1. In 5 patients more than 1 pathogen has been found. In all patient with a positive PCR result no acute systemic symptoms as fever etc. were present. In no case the positive PCR recult was followed by therapeutic consequences.
Conclusion: Positive PCR results in BAL fluid are common in these patients. A causal link to symptoms is not possible without immunohistochemistry of bronchial or lung tissue. However, the findings could be in part an explanation for chronic bronchial obstruction in nearly half of the cases. Direct consequenses of PCR findings for treatrment, however, are rare.

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Citations should be made in the following way:
B. Lepper, F. Ahrens, J. Weigl, F. Riedel (Hamburg, Kiel, Germany). Is infection screening in BAL fluid useful in children with chronic obstructive airway disease unresponsive to anti-asthmatic treatment?. Eur Respir J 2006; 28: Suppl. 50, 1786

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