Multiple Respiratory Microbiota Profiles Are Associated With Lower Airway Inflammation in Children With Protracted Bacterial Bronchitis

Marsh, Robyn L.; Smith‐Vaughan, Heidi; Chen, Alice C.‐H.; Marchant, Julie M.; Yerkovich, Stephanie T.; Gibson, Péter G.; Pizzutto, Susan J.; Hodge, Sandra; Upham, John W.; Chang, Anne B.

doi:10.1016/j.chest.2019.01.002

Cited by 25 publications

(29 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Co-infection could be found in the identified studies, some patients were caused by multiple bacteria and several cases were co-infected by bacteria and viruses [1,14]. Consistent with the findings, microbiota dysbiosis can be found in the BALF of patients with PBB [23] and the inflammation may not be driven by single bacteria [24]. Viruses also can be detected in BALF of patients with PBB, however, there was no evidence to prove that PBB was virus-induced [25].…”

Section: Discussionsupporting

confidence: 53%

Update on protracted bacterial bronchitis in children

2020

View full text Add to dashboard Cite

Background: Chronic cough is a common symptom in children and protracted bacterial bronchitis (PBB) is one of the causes of chronic cough. However, the understanding of this disease remains limited. The present study aims to update PBB in children. Methods: The clinical data of children with PBB from 2014 to 2018 were retrospectively analyzed, and PBB clinical features of published studies were summarized. Electronic databases were searched in May 2019. Clinical studies were included in the present study. Reviews were undertaken in duplicate. Results: Totally 712 cases were analyzed in this study, including 52 cases in our center and 660 cases from 14 studies. In the 52 cases, 88.5% of patients with PBB were less than 6 years old and all of them complained of wet cough. Three cases were confirmed with laryngomalacia, and microbiologically-based-PBB were identified in 13 cases (9 Streptococcus pneumonia, 3 Staphylococcus aureus, and 1 Pseudomonas aeruginosa). Twenty cases were completely remitted after treatment. In the 14 studies, the patients with PBB were typically younger than 3 years old, accompanying wheezing and airway malacia. Co-infection was common in most western cases, Streptococcus pneumonia, Haemophilus influenza and Moraxella catarrhalis were the top three pathogens. Symptoms were improved in most patients, whereas some cases with comorbidities required prolonged antibiotics treatment. Conclusions: PBB is common in male infants with chronic wet cough and accompanied by wheezing and airway deformities. Most cases are clinically diagnosed PBB in China and microbiologically-based-PBB is common in western countries. Co-infection could be found, Streptococcus pneumoniae and Haemophilus influenza were the most frequent etiology in China and western countries, respectively. Patients with comorbidities may need extended antibiotics treatment for more than 2 weeks.

show abstract

Section: Discussionsupporting

confidence: 53%

Update on protracted bacterial bronchitis in children

2020

View full text Add to dashboard Cite

show abstract

“…35 Prevotella species have been associated with protracted bacterial bronchitis in children. 36 In a study of subjects with stable COPD, increased bacterial burden in the airways was associated with FEV 1 decline over time. The common bacteria that were cultured from sputum included Streptococcus viridans, Nesseria spp., Corynebacterium, as well as Hemophilus spp., all of which are normal oral flora.…”

Section: Aspiration Of Oral Bacteriamentioning

confidence: 99%

The Oral-Lung Axis: The Impact of Oral Health on Lung Health

et al. 2020

View full text Add to dashboard Cite

Poor oral health has long been recognized as a clinical risk factor for developing lung infections. Recent data using culture-independent techniques assessing the microbiome in healthy subjects have demonstrated that chronic microaspiration establishes a very similar microbial community between the mouth and lung, suggesting these 2 anatomic regions are closely intertwined. Dental disease is driven and aided by a dysbiosis in the oral microbiome, and evidence is mounting that implicates the microbiome in a variety of lung diseases including asthma, COPD, pulmonary fibrosis, and pneumonia. This review describes common dental conditions and potential mechanisms by which poor oral health may contribute to lung disease. We also review the current literature drawing associations between poor oral health and lung disease.

show abstract

“…Moreover, children with PBB showed that a higher BAL bacterial biomass strongly correlated with neutrophilic inflammation. PBB-microbiota were different to control-microbiota and clustered into four distinct microbiota patterns where respiratory pathogen or other microbiota species (e.g., Prevotella ) have been detected ( 25 ). The cultures of respiratory pathogens, inflammatory markers, and BAL bacterial biomass were found to not be associated with this variation in alpha diversity among subjects with PBB.…”

Section: Etiopathogenesismentioning

confidence: 99%

When the Cough Does Not Improve: A Review on Protracted Bacterial Bronchitis in Children

et al. 2020

View full text Add to dashboard Cite

Chronic cough is defined as a daily cough that persists longer than 4 weeks. Protracted bacterial bronchitis (PBB) is a common cause of chronic wet cough in preschool children with no symptoms or signs of other specific causes, and resolution usually follows a 2-week course of an appropriate oral antibiotic. The diagnosis is mainly clinical; generally, no instrumental examinations are necessary. The most common bacteria found in the bronchoalveolar lavage (BAL) of subjects with PBB include Haemophilus influenzae, Streptococcus pneumoniae , and Moraxella catarrhalis . Nowadays, there is no certain evidence of the role of viruses in PBB pathogenesis even though different types of viruses have been detected in BAL from children with PBB. Airway malacia is commonly found in children with PBB; conversely, there is no correlation with any type of immunodeficiency. Amoxicillin-clavulanate acid is the most commonly used antibiotic, as first-line, prolonged therapy (longer than 2 weeks) is sometimes required to cough resolution. When the wet cough does not improve despite prolonged antibiotic treatment, an underlying disease should be considered. Moreover, there are several hypotheses of a link between PBB and bronchiectasis, as recent evidences show that recurrent PBB (>3 episodes/years) and the presence of H. influenzae infection in the lower airways seem to be significant risk factors to develop bronchiectasis. This underlines the importance of a close follow-up among children with PBB and the need to consider chest computerized tomography (CT) in patients with risk factors for bronchiectasis. In this brief review, we summarize the main clinical and pathogenetic findings of PBB, a disease that may be related to a relevant morbidity and decreased quality of life during the pediatric age.

show abstract

Multiple Respiratory Microbiota Profiles Are Associated With Lower Airway Inflammation in Children With Protracted Bacterial Bronchitis

Cited by 25 publications

References 40 publications

Update on protracted bacterial bronchitis in children

Update on protracted bacterial bronchitis in children

The Oral-Lung Axis: The Impact of Oral Health on Lung Health

When the Cough Does Not Improve: A Review on Protracted Bacterial Bronchitis in Children

Contact Info

Product

Resources

About