Is protracted bacterial bronchitis a new nosological group or an old problem of differential diagnosis of chronic cough in children?

Abstract

The purpose is to study the clinical-anamnestic and microbiological features of the protracted bacterial bronchitis (PBB), recurrent bronchitis (RB), chronic bronchitis (CB) in children and to determine the risk factors for the development of chronic bronchitis. Materials and methods. A total of 89 children were examined, among them 21 children with PBB, 27 children with RB and 41 children with CB. The study included the collection of anamnesis, objective examination, chest X-ray, bronchoscopy and microbiological examination of the bronchial mucosa and upper respiratory tract composition. Results. An analysis of РВВ clinical features showed that their total duration was 4.1 ± 0.3 weeks. In children with RB, the duration of exacerbations did not differ significantly and was 3.8 ± 0.4 weeks. In patients with CB, the annual number of bronchitis and the total duration of cough were two times higher than in patients with RB. Bacteriological analysis showed that Streptococcus pneumonia was the most frequent causative agent of the disease in children with PBB and RB. In children with exacerbation of CB, Haemophilus influenzae was more commonly identified. At the same time, such a representative of the normal bronchial microbiome as Aerococcus viridans, was identified in 81.0 % of PBB patients, in 33.3 % of RB patients, and in 8.7 % of CB patients. Conclusions. The study showed that risk factors for СВ development in children with PBВ and RB are the lower respiratory tract H. influenzae colonization and decreased activity or absence of the normal airway microbiota (Aerococcus viridans).

Keywords

• cough
• bronchitis
• chronic bronchitis
• child