High viral frequency in children with gastroesophageal reflux-related chronic respiratory disorders.
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.
Calabrese
Fiorella
F
Department of Medical-Diagnostic Sciences and Special Therapies, University of Padua, Padua, Italy. fiorella.calabrese@unipd.it
Rizzo
Stefania
S
Giacometti
Cinzia
C
Panizzolo
Cristina
C
Turato
Graziella
G
Snijders
Deborah
D
Lunardi
Francesca
F
Vadori
Marta
M
Valente
Marialuisa
M
Saetta
Marina
M
Barbato
Angelo
A
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