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Wet cough in children: infective and inflammatory characteristics in broncho-alveolar lavage fluid

Wurzel, Danielle F., Marchant, Julie M., Clark, Julia E., Masters, Ian B., Yerkovich, Stephanie T., Upham, John W. and Chang, Anne B. (2014). Wet cough in children: infective and inflammatory characteristics in broncho-alveolar lavage fluid. Pediatric Pulmonology,49(6):561-568.

Document type: Journal Article
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Title Wet cough in children: infective and inflammatory characteristics in broncho-alveolar lavage fluid
Author Wurzel, Danielle F.
Marchant, Julie M.
Clark, Julia E.
Masters, Ian B.
Yerkovich, Stephanie T.
Upham, John W.
Chang, Anne B.
Journal Name Pediatric Pulmonology
Publication Date 2014
Volume Number 49
Issue Number 6
ISSN 8755-6863   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84879060609
Start Page 561
End Page 568
Total Pages 8
Place of Publication United States
Publisher John Wiley & Sons, Inc.
HERDC Category C1 - Journal Article (DIISR)
Abstract Wet cough is a common feature of many disease processes affecting children. Our aim was to examine the relationships between cough nature, lower airway infection (bacterial, viral, and viral–bacterial) and severity of neutrophilic airway inflammation. We hypothesized that viral–bacterial co-infection of the lower airway would be associated with wet cough and heightened neutrophilic airway inflammation. We prospectively recruited 232 children undergoing elective flexible bronchoscopy. Participants were grouped using a cough nature symptom-based approach, into wet, dry or no cough groups. Broncho-alveolar lavage (BAL) and clinical data, including presence, nature, and duration of cough and key demographic factors, were collected. Children with wet cough (n = 143) were more likely to have lower airway bacterial infection (OR 2.6, P = 0.001), viral infection (OR 2.04, P = 0.045) and viral–bacterial co-infection (OR 2.65, P = 0.042) compared to those without wet cough. Wet cough was associated with heightened airway neutrophilia (median 19%) as compared to dry or no cough. Viral–bacterial co-infection was associated with the highest median %neutrophils (33.5%) compared to bacteria only, virus/es only and no infection (20%, 18%, and 6%, respectively, P < 0.0001). Children with wet cough had higher rates of lower airway infection with bacteria and viruses. Maximal neutrophilic airway inflammation was seen in those with viral–bacterial co-infection. Cough nature may be a useful indicator of infection and inflammation of the lower airways in children. Pediatr Pulmonol. 2014; 49:561–568. © 2013 Wiley Periodicals, Inc.
Keywords airway inflammation
bacterial infections
respiratory tract
viral infections
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Created: Thu, 07 Aug 2014, 17:23:03 CST