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. 2022 Nov 1;22(1):814.
doi: 10.1186/s12879-022-07749-w.

Nasopharyngeal aspirates in children with severe community-acquired pneumonia collected within 3 days before bronchoscopy can partially reflect the pathogens in bronchoalveolar lavage fluids

Qiguo Zhu  1 , Junli Zhou  1 , Fei Li  2 , Peng Shi  3 , Yi Lu  1 , Xiaoliang Lin  1 , Lin Yuan  1 , Zhiqiang Zhuo  1 , Jun Shen  4
Affiliations

Nasopharyngeal aspirates in children with severe community-acquired pneumonia collected within 3 days before bronchoscopy can partially reflect the pathogens in bronchoalveolar lavage fluids

Qiguo Zhu et al. BMC Infect Dis. .

Abstract

Background: There is little evidence about consistency between nasopharyngeal and pulmonary pathogens in children with severe pneumonia. This study aims to compare the difference of pathogens between nasopharyngeal aspirates (NPAs) collected before bronchoscopy and bronchoalveolar lavage fluids (BALFs) in children with severe community-acquired pneumonia (SCAP).

Methods: NPAs and BALFs were collected form pediatric SCAP cases hospitalized from January 2018 to March 2019. NPAs were colleced within 3 days before bronchoscopy. Samples were detected by direct immunofluorescence assay (DFA) for seven respiratory viruses and by routine bacterial culture in the clinical microbiology laboratory. Respiratory syncytial virus (RSV), Adenovirus (ADV), Influenza virus types A, B (IV-A and IV-B), Parainfluenza virus 1-3 (PIV1-3) were detected with a commercial assay. The virological and bacteriological detention results of NPAs were compared with the results of BALFs.

Results: In total 204 cases with mean age of 3.4 ± 2.8 years (IQR, 1 month-14 years) were included in the study. Both NPA and BALF were collected from those cases. The positive rates of pathogen in NPAs and BALFs were 25.0% (51/204) and 36.7% (75/204), respectively (x2 = 6.614, P = 0.010). Respiratory viruses were found in 16.1% (33/204) from NPAs and 32.3% (66/204) from BALFs (x2 = 14.524, P < 0.001). RSV and ADV were the two most frequent detected viruses in NPAs and BALFs. High consistentcy of pathogens between NPAs and BALFs was observed, and 96.9% (32/33) viruses detected in NPAs were also found in BALFs. While bacteria were isolated from 12.7% (26/204) and 10.7% (22/204) of the two kinds of samples, respectively (x2 = 0.378, P = 0.539). In addition, Haemophilus influenzae (HI) was the dominant germ in both samples.

Conclusion: The DFA method used to detect seven respiratory viruses from NPAs collected within 3 days before bronchoscopy can partially reflect the pathogens in the lungs in children with SCAP.

Keywords: Bronchoalveolar lavage fluid; Children; Etiology; Nasopharyngeal aspirate; Severe community-acquired pneumonia.

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Conflict of interest statement

The authors declared that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart to enroll the cases and collect samples sent for pathogens detection in this study. Both NPAs and BALFs from the same case were tested by DFA and routine bacterial culture
Fig. 2
Fig. 2
RSV and ADV were the two most frequently detetced viruses in both NPAs and BALFs. HI was the bacterium with the highest positive rate in both kind of samples
Fig. 3
Fig. 3
Higher rate of viruses were detected in BALFs compared to NPAs. However, minor difference of bacteria positive rates was observed between the two kind of samples
Fig. 4
Fig. 4
In NPAs and BALFs from the same patients, difference in the positive rates of respiratory virus was observed, but not in the positive rates of bacteria
See this image and copyright information in PMC

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