Correlation between bronchoalveolar lavage cultures and nasopharyngeal swab cultures in wheezy children.

Coughing and wheezing are very common symptoms of childhood. Many children, up to 50% of wheeze at some time during the first 6 years of life.
Studies have shown that, even at 9-10 years, wheezy children may have decreased lung function. This early decrease in lung function may go on to cause problems and lung disease in adult life. This makes it very important to understand what causes cough and wheezing in young children.

One of the known causes of uncontrolled cough and wheezing in children is “persistent bacterial bronchitis” or “PBB”. It happens in children below 5 years of age, when they have infection in their lungs causing the uncontrolled cough and wheezing. Doctors often think the problem is asthma, and it can happen at the same time as asthma, but if it is not treated, the symptoms will continue and child will not responding to his medicines.

PBB is diagnosed by culturing the fluid lung specialists get from the patient’s airways during bronchoscopy, a procedure done in the operating room with the child asleep. The fluid is removed from the lung through a scope down in the child’s lung. This procedure can be hard on a child, so some doctors choose to treat their children by giving antibiotics for 2 weeks as a guess. The problem is that this will miss the other possible causes for the cough and may delay the child improving.

Our research plans to test an easier and simpler method to diagnose PBB in children. We want to find out if we can use a nasopharyngeal swab culture (a cotton swab of the nose) in place of the culture from the lungs in wheezing children. We will culture the nose of children having a bronchoscopy done to see if the two cultures are the same in the same child. If so, we can recommend doctors swab the nose of children in their offices to treat infection first before referring those children to lung specialists for bronchoscopy or other work-up.

Study phase: N/A

Basic eligibility criteria:
Please contact the study coordinator for additional eligibility information.

1-Pediatric subject between the ages of one month and 5 years.
2-Subject followed by the pediatric pulmonary team outpatient clinics, or referred to the pulmonary service for the complaint of uncontrolled chronic cough and or wheezing.
3-Subject undergoing a flexible fiberoptic bronchoscopy with BAL as part of a workup for uncontrolled cough and wheeze.
4-Subject’s BAL being sent for cultures to rule out persistent bacterial bronchitis

Primary disease category: Asthma & Lung

Projected enrollment dates: December 2015 to December 2016

Official study title: Correlation between bronchoalveolar lavage cultures and nasopharyngeal swab cultures in wheezy children.