title: High viral frequency in children with gastroesophageal reflux-related chronic respiratory disorders.
abstract: BACKGROUND
  In the pediatric population chronic respiratory disorders (CRDs) include many pathological entities in which gastroesophageal reflux (GER) may play a role in the induction or persistence of clinical symptoms. It is not well established whether infective agents may be present in lung aspiration. The aim of the work was to investigate whether different infective agents could be found in children with GER-related CRDs.
  
  
  METHODS
  Extensive microbiological investigations including culture for bacterial agents, serology, direct fluorescent antigen and polymerase chain reaction analyses for different respiratory viruses were performed in 32 children (18 males, 14 females, mean age 5.0 +/- 2.4 years). Fifteen children out of 32 considered as "aspirators" (lipid-laden macrophage index-LLMI->or=86 and pathological pH-assay) were compared to 17 "non-aspirators" (LLMI < 86 and normal pH-assay).
  
  
  RESULTS
  Aspirators were older (6.0 +/- 1.9 vs. 4.2 +/- 2.5 years, P = 0.006) and less frequently atopic (13% vs. 59%, P = 0.01) than non-aspirators. A high frequency of viral infections (20/32, 62.5%) was found, with frequent occurrence of multiple infections (10/20, 50%). Aspirators showed more frequent viral infections than non-aspirators (87% vs. 41%, P = 0.01). Rhinovirus and respiratory syncytial virus were the principal detected viruses in the aspirator group.
  
  
  CONCLUSIONS
  Viral infections could play a key role in the pathogenesis of GER-related CRDs.
authors.affiliation: Department of Medical-Diagnostic Sciences and Special Therapies, University of Padua, Padua, Italy. fiorella.calabrese@unipd.it
authors.forename: Fiorella
authors.initials: F
authors.lastname: Calabrese
authors.forename: Stefania
authors.initials: S
authors.lastname: Rizzo
authors.forename: Cinzia
authors.initials: C
authors.lastname: Giacometti
authors.forename: Cristina
authors.initials: C
authors.lastname: Panizzolo
authors.forename: Graziella
authors.initials: G
authors.lastname: Turato
authors.forename: Deborah
authors.initials: D
authors.lastname: Snijders
authors.forename: Francesca
authors.initials: F
authors.lastname: Lunardi
authors.forename: Marta
authors.initials: M
authors.lastname: Vadori
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Valente
authors.forename: Marina
authors.initials: M
authors.lastname: Saetta
authors.forename: Angelo
authors.initials: A
authors.lastname: Barbato
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000821:virology*; D002675:Child, Preschool; D002908:Chronic Disease; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012140:Respiratory Tract Diseases / Q000382:microbiology* / Q000821:virology*; D012229:Rhinovirus / Q000302:isolation & purification