TY - JOUR
T1 - Bacterial Colonization of the Lower Airways in Children With Esophageal Atresia
AU - van Tuyll van Serooskerken, Eleonora Sofie
AU - Duhoky, Rauand
AU - Verweij, Johannes W
AU - Bont, Louis
AU - Arets, Hubertus G M
AU - Bittermann, Arnold J N
AU - van der Zee, David C
AU - Tytgat, Stefaan H A J
AU - Lindeboom, Maud Y A
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - BACKGROUND: Esophageal atresia (EA) is most often accompanied by some degree of tracheomalacia (TM), which negatively influences the airway by ineffective clearance of secretions. This can lead to lower airway bacterial colonization (LABC), which may cause recurrent respiratory tract infections (RTIs). This study aims to evaluate the prevalence and specific pathogens of LABC in EA patients.METHODS: A 5-year retrospective single-site cohort study was conducted including all EA patients that had undergone an intraoperative bronchoalveolar lavage (BAL) during various routine surgical interventions. Concentrations of greater than 10 cfu were considered evidence of LABC.RESULTS: We recruited 68 EA patients, of which 12 were excluded based on the exclusion criteria. In the remaining 56 patients, a total of 90 BAL samples were obtained. In 57% of the patients, at least 1 BAL sample was positive for LABC. Respiratory symptoms were reported in 21 patients at the time of the BAL, of which 10 (48%) had LABC. Haemophilus influenzae (14%) and Staphylococcus aureus (16%) were most frequently found in the BAL samples. The number of respiratory tract infections and the existence of a recurrent fistula were significantly associated with LABC (P = 0.008 and P = 0.04, respectively).CONCLUSIONS: This is the first study showing that patients with EA have a high prevalence of bacterial colonization of the lower airways which may be a leading mechanism of severe and recurrent respiratory complications.
AB - BACKGROUND: Esophageal atresia (EA) is most often accompanied by some degree of tracheomalacia (TM), which negatively influences the airway by ineffective clearance of secretions. This can lead to lower airway bacterial colonization (LABC), which may cause recurrent respiratory tract infections (RTIs). This study aims to evaluate the prevalence and specific pathogens of LABC in EA patients.METHODS: A 5-year retrospective single-site cohort study was conducted including all EA patients that had undergone an intraoperative bronchoalveolar lavage (BAL) during various routine surgical interventions. Concentrations of greater than 10 cfu were considered evidence of LABC.RESULTS: We recruited 68 EA patients, of which 12 were excluded based on the exclusion criteria. In the remaining 56 patients, a total of 90 BAL samples were obtained. In 57% of the patients, at least 1 BAL sample was positive for LABC. Respiratory symptoms were reported in 21 patients at the time of the BAL, of which 10 (48%) had LABC. Haemophilus influenzae (14%) and Staphylococcus aureus (16%) were most frequently found in the BAL samples. The number of respiratory tract infections and the existence of a recurrent fistula were significantly associated with LABC (P = 0.008 and P = 0.04, respectively).CONCLUSIONS: This is the first study showing that patients with EA have a high prevalence of bacterial colonization of the lower airways which may be a leading mechanism of severe and recurrent respiratory complications.
KW - bronchoalveolar lavage
KW - esophageal atresia
KW - lower airway bacterial colonization
KW - respiratory tract infections
UR - http://www.scopus.com/inward/record.url?scp=85165517738&partnerID=8YFLogxK
U2 - 10.1097/INF.0000000000003953
DO - 10.1097/INF.0000000000003953
M3 - Article
C2 - 37171938
SN - 0891-3668
VL - 42
SP - 644
EP - 647
JO - The Pediatric infectious disease journal
JF - The Pediatric infectious disease journal
IS - 8
ER -