wheeze in preschool age is associated with pulmonary bacterial infection and resolves after antibiotic therapy喘息在幼儿园时代与肺部细菌感染,抗生素治疗后解决.pdfVIP

Wheeze in Preschool Age Is Associated with Pulmonary Bacterial Infection and Resolves after Antibiotic Therapy 1. 1. 2. 1 . 1. Nicolaus Schwerk , Folke Brinkmann , Bisharah Soudah , Michael Kabesch * , Gesine Hansen 1 Department of Pneumology, Allergy and Neonatology, University Children’s Hospital, Hanover Medical School, Hanover, Germany, 2 Institute of Pathology, Hanover Medical School, Hanover, Germany Abstract Background: Neonates with airways colonized by Haemophilus influenzae, Streptococcus pneumoniae or Moraxella catarrhalis are at increased risk for recurrent wheeze which may resemble asthma early in life. It is not clear whether chronic colonization by these pathogens is causative for severe persistent wheeze in some preschool children and whether these children might benefit from antibiotic treatment. We assessed the relevance of bacterial colonization and chronic airway infection in preschool children with severe persistent wheezing and evaluated the outcome of long-time antibiotic treatment on the clinical course in such children. Methodology/Principal Findings: Preschool children (n = 42) with severe persistent wheeze but no symptoms of acute pulmonary infection were investigated by bronchoscopy and bronchoalveolar lavage (BAL). Differential cell counts and microbiological and virological analyses were performed on BAL samples. Patients diagnosed with bacterial infection were treated with antibiotics for 2–16 weeks (n = 29). A modified ISAAC questionnaire was used for follow-up assessment of children at least 6 months after bronchoscopy. Of the 42 c