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Protracted bacterial bronchitis in young children: association with airway malacia

Michelle Kompare1, Miles Weinberger

  • 1Pediatric Department, University of Iowa Children's Hospital, Iowa City, IA, USA.

The Journal of Pediatrics
|August 27, 2011
PubMed

Insights

Protracted bacterial bronchitis in young children is identified by high bacterial counts in bronchoalveolar lavage (BAL). Airway malacia is common, and while antibiotics resolve symptoms, relapses occur, suggesting potential for chronic airway damage.

Area of Science:

  • Pediatric Pulmonology
  • Microbiology
  • Respiratory Medicine

Background:

  • Prolonged cough, wheeze, and noisy breathing are common in young children.
  • Identifying the cause of these persistent respiratory symptoms is crucial for effective treatment.
  • Bronchoalveolar lavage (BAL) can help diagnose bacterial infections in the lower airways.

Purpose of the Study:

  • To investigate associated findings and clinical outcomes in young children with persistent respiratory symptoms.
  • To determine the significance of high bacterial colony counts in BAL fluid.
  • To explore the relationship between bacterial infections and airway anomalies.

Main Methods:

  • Retrospective review of medical records for children aged 0-60 months with protracted respiratory symptoms.
  • Analysis of BAL fluid cultures for bacterial counts (≥ 10^4 CFU/mL).
  • Assessment for airway malacia (tracheomalacia/bronchomalacia) and clinical outcomes.

Main Results:

  • 70 children had high counts of Streptococcus pneumoniae, Haemophilus influenza, or Moraxella catarrhalis in BAL.
  • Neutrophilia was present in 87% of BAL samples.
  • Airway malacia was observed in 74% of children, and antibiotic treatment resolved symptoms in all cases with follow-up, though 43% relapsed.

Conclusions:

  • High bacterial counts and neutrophilia in BAL diagnose protracted bacterial bronchitis.
  • Airway malacia appears to play a significant role in the etiology of this condition.
  • Further research is needed to understand the long-term consequences of protracted bacterial bronchitis on airway health.
Abstract

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