Bacteria isilated from the airways of paediatric patients with bronchiectasis according to HIV status

Abstract

Background: It is routine to take airway samples from patients with bronchiectasis to determine the bacteria that colonize their airways. This guides the choice of antimicrobials to use when they have chest infection. It is not known whether there is a difference between the number, type and density of bacteria found in the airways of human immunodeficiency virus (HIV) positive and negative patients with bronchiectasis. Objective: To determine the bacteria isolated from the airways of children with bronchiectasis according to their HIV status. Methods: Records of children under 16 years of age with the diagnosis of bronchiectasis who had been seen by division of paediatric pulmonology at CHBAH between April 2011 and March 2013 were reviewed. Data were collected on the patient demographics, HIV status and characteristics of the airway samples collected from all the patients. Data collected on the airway samples included number of samples collected per patient, type and quality of the samples collected, number and type of organisms cultured and density of individual organisms cultured. Comparisons between HIV negative and positive patients were made. Results: A total of 78 patients with bronchiectasis were seen by the division of pulmonology over this 2 year period. Their mean age was 9.7±3.3 years. The majority of patients (79.5%) were HIV positive. 175 samples were collected and of these 85.7% were expectorated sputum. Gram negative bacteria (71.6%) were more common than gram positive bacteria (28.4%). H. influenzae was the most common bacteria identified (36.0%) followed by S. pneumoniae (13.1%), S. aureus (11.3%) and M. catarrhalis (10.8%). When comparing HIV positive and negative patients with bronchiectasis there was no difference in the number, type and density of bacteria isolated. Conclusion: Number, type and density of bacteria isolated in the airways of children with bronchiectasis is not associated with the HIV status of the patient.