Is protracted bacterial bronchitis a new nosological group or an old problem of differential diagnosis of chronic cough in children?
DOI:
https://doi.org/10.14739/2310-1210.2019.4.173341Keywords:
cough, bronchitis, chronic bronchitis, childAbstract
The purpose is to study the clinical-anamnestic and microbiological features of the protracted bacterial bronchitis (PBB), recurrent bronchitis (RB), chronic bronchitis (CB) in children and to determine the risk factors for the development of chronic bronchitis.
Materials and methods. A total of 89 children were examined, among them 21 children with PBB, 27 children with RB and 41 children with CB. The study included the collection of anamnesis, objective examination, chest X-ray, bronchoscopy and microbiological examination of the bronchial mucosa and upper respiratory tract composition.
Results. An analysis of РВВ clinical features showed that their total duration was 4.1 ± 0.3 weeks. In children with RB, the duration of exacerbations did not differ significantly and was 3.8 ± 0.4 weeks. In patients with CB, the annual number of bronchitis and the total duration of cough were two times higher than in patients with RB. Bacteriological analysis showed that Streptococcus pneumonia was the most frequent causative agent of the disease in children with PBB and RB. In children with exacerbation of CB, Haemophilus influenzae was more commonly identified. At the same time, such a representative of the normal bronchial microbiome as Aerococcus viridans, was identified in 81.0 % of PBB patients, in 33.3 % of RB patients, and in 8.7 % of CB patients.
Conclusions. The study showed that risk factors for СВ development in children with PBВ and RB are the lower respiratory tract H. influenzae colonization and decreased activity or absence of the normal airway microbiota (Aerococcus viridans).
References
Shields, M. D., Bush, A., Everard, M. L., McKenzie, S., & Primhak, R. (2008). British Thoracic Society Cough Guideline Group. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax, 63(3), iii1–iii15. doi: 10.1136/thx.2007.077370
MOZ Ukrainy (2015) Unifikovanyi klinichnyi protokol pervynnoi medychnoi dopomohy «Kashel u ditei vikom vid shesty rokiv» [Unified clinical protocol for primary care "Cough in children from six years old"]. Kyiv. [in Ukrainian].
Samsygina, G. A. (2015). Khronicheskij kashel' v detskom vozraste [Chronic cough in children] Pediatriya. Zhurnal im. G. N. Speranskogo, 94(4), 163–170. [in Russian].
Marchant, J. M., Masters, I. B., Taylor, S. M., Cox, N. C., Seymour, G. J., & Chang, A. B. (2006). Evaluation and outcome of young children with chronic cough. Chest, 129(5), 1132–1141. doi: 10.1378/chest.129.5.1132
Kantar, A., Chang, A. B., Shields, M. D., Marchant J. M., Grimwood K., Grigg J., et al. (2017). ERS statement on protracted bacterial bronchitis in children. European Respiratory Journal, 50(2). doi: 10.1183/13993003.02139-2016
Filippo, P. D., Scaparrotta, A., Petrosino, M. I., Attanasi, M., Di Pillo S., Chiarelli F., & Mohn, A. (2018). An underestimated cause of chronic cough: The protracted bacterial bronchitis. Annals of Thoracic Medicine, 13(1), 7–13. doi: 10.4103/atm.ATM_12_17. doi: 10.4103/atm.ATM_12_17
Craven, V., & Everard, M. L. (2013) Protracted bacterial bronchitis: Reinventing an old disease. Arch Dis Child, 98(1), 72–76. doi: 10.1136/archdischild-2012-302760
Chang, A. B., Robertson, C. F., Van Asperen, P. P., Glasgow, N. J., Mellis, C. M., Masters, I. B., et al. (2012). A multicenter study on chronic cough in children: Burden and etiologies based on a standardized management pathway. Chest, 142(4), 943–950. doi: 10.1378/chest.11-2725
Gedik, A. H., Cakir, E., Torun, E., Demir, A. D., Kucukkoc, M., Erenberk, U., et al. (2015). Evaluation of 563 children with chronic cough accompanied by a new clinical algorithm. Ital J Pediatr, 41(1), 1–7. doi: 10.1186/s13052-015-0180-0
Bidiwala, A., Krilov, L. R., Pirzada, M., & Patel, S. J. (2015). Pro-Con Debate: Protracted Bacterial Bronchitis as a Cause of Chronic Cough in Children. Pediatr Ann, 44(8), 329–336. doi: 10.3928/00904481-20150812-11
Zgherea, D., Pagala, S., Mendiratta, M., Marcus, M. G., Shelov, S. P., & Kazachkov, M. (2012). Bronchoscopic findings in children with chronic wet cough. Pediatrics, 129(2), 364–369. doi: 10.1542/peds.2011-0805
Paul, S. P., & Hilliard, T. (2014) The importance of recognizing protracted bacterial bronchitis in children. Indian J Pediatr, 81(1), 1–3. doi: 10.1007/s12098-013-1197-2
Craven, V., & Everard, M. L. (2013). Protracted bacterial bronchitis: Reinventing an old disease. Arch Dis Child, 98(1), 72–6. doi: 10.1136/archdischild-2012-302760
Narang, R., Bakewell, K., Peach, J., Clayton, S., Samuels, M., Alexander, J., et al. (2014) Bacterial distribution in the lungs of children with protracted bacterial bronchitis. PLoS One, 9(9), e108523. doi: 10.1371/journal.pone.0108523
Іlchenko, S. І., & Fialkovska, А. О. (2018). Dіahnoz «khronіchnyi bronkhіt» v dytiachіi pulmonolohіi: «za» ta «proty» [Diagnosis "chronic bronchitis" in children's pulmonology: "pro" and "contra"]. Ukrainskyi pulmonolohichnyi zhurnal, 4, 32–34. [in Ukrainian].
Goyal, V., Grimwood, K., Marchant, J. M., Masters, I. B., & Chang, A. B. (2016). Paediatric chronic suppurative lung disease: clinical characteristics and outcomes. Eur J Pediatr, 175(8), 1077–1084. doi: 10.1007 / s00431-016-2743-5
Duka, K. D., Ilchenko, S. І., & Іvanus, S. G. (2013). Khronichnyi bronkhit u ditei ta pidlitkiv – mynule, suchasne i maibutnie [Chronic bronchitis in children and adolescents - past, present and future]. Dnipropetrovsk. [in Ukrainian].
Antipkin, Y. G., Lapshin, V. F., Umanec, T. R. (2009). Recidiviruyushhij bronkhit u detej: diskussionnye voprosy [Recurrent bronchitis in children: discussion questions]. Zdorovia Ukrainy, 18(1), 19–21. [in Russian].
Wurzel, D. F., Marchant, J. M., Yerkovich, S. T., Upham, J. W., Petsky, H. L., Smith-Vaughan, H., et al. (2016). Protracted Bacterial Bronchitis in Children: Natural History and Risk Factors for Bronchiectasis. Chest, 150(5), 1101–1108. doi: 10.1016 / j.chest.2016.06.030
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