Bacteria isolated from the airways of paediatric patients with bronchiectasis according to HIV status
Charl Verwey1, Sithembiso Velaphi, Riaz Khan
1Department of Paediatrics, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. charl.verwey@wits.ac.za.
Insights
Bacterial infections in children with non-cystic fibrosis bronchiectasis are common, with Gram-negative bacteria like Haemophilus influenzae predominating. HIV status did not influence the types of bacteria found in airway samples.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Microbiology
Background:
- Establishing empirical antibiotic guidelines for pediatric non-cystic fibrosis bronchiectasis requires understanding common airway bacteria.
- Identifying these pathogens is crucial for effective treatment of acute infective exacerbations.
Purpose of the Study:
- To characterize airway bacteria in children with non-cystic fibrosis bronchiectasis.
- To investigate the influence of human immunodeficiency virus (HIV) status on isolated pathogens.
Main Methods:
- Retrospective review of patient records (April 2011-March 2013) at a South African academic hospital.
- Data collection included demographics, HIV status, and airway sample analysis.
- Identified bacteria from sputum and other respiratory samples.
Main Results:
- Sixty-six children with non-cystic fibrosis bronchiectasis were studied; 78.8% were HIV-infected.
- Gram-negative bacteria constituted 72.1% of isolates, with Haemophilus influenzae being the most frequent (36.0%).
- Prevalence and types of bacteria were similar between HIV-infected and uninfected children.
Conclusions:
- Airway bacterial isolates in children with non-cystic fibrosis bronchiectasis are comparable to other pediatric groups.
- HIV status does not significantly alter the spectrum of bacterial pathogens identified in this population.
Background:
Knowledge of which bacteria are found in the airways of paediatric patients with bronchiectasis unrelated to cystic fibrosis (CF) is important in defining empirical antibiotic guidelines for the treatment of acute infective exacerbations.
Objective:
To describe the bacteria isolated from the airways of children with non-CF bronchiectasis according to their HIV status.
Methods:
Records of children with non-CF bronchiectasis who attended the paediatric pulmonology clinic at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, from April 2011 to March 2013, or were admitted to the hospital during that period, were reviewed. Data collected included patient demographics, HIV status, and characteristics of the airway samples and types of bacteria isolated.
Results:
There were 66 patients with non-CF bronchiectasis over the 2-year study period. The median age was 9.1 years (interquartile range 7.2 - 12.1). The majority of patients (78.8%) were HIV-infected. A total of 134 samples was collected (median 1.5 per patient, range 1 - 7), of which 81.3% were expectorated or induced sputum samples. Most bacteria were Gram negatives (72.1%). Haemophilus influenzae was the most common bacterium identified (36.0%), followed by Streptococcus pneumoniae (12.6%), Moraxella catarrhalis (11.1%) and Staphylococcus aureus (10.6%). There were no differences between HIV-infected and uninfected patients in prevalence or type of pathogens isolated.
Conclusion:
Bacterial isolates from the airways of children with non-CF bronchiectasis were similar to those in other paediatric populations and were not affected by HIV status.
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