PCR based bronchoscopic detection of common respiratory pathogens in chronic cough: a case control study

Cough

Jaclyn A Smith⁴  Ashley A Woodcock³  James P Stewart⁵  Paul W Bishop²  Winifred Dove⁶  Samantha Decalmer¹  Angela Kelsall³  Peter W West³ 

[1] Respiratory Research Group, Faculty of Medical and Human Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK;Directorate of Clinical Laboratory Medicine, University Hospital of South Manchester, Manchester, UK;NIHR Translational Research Facility in Respiratory Medicine, North West Lung Research Centre, University Hospital of South Manchester, Manchester, UK;Respiratory Research Group, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester, M23 9LT, UK;Department of Infection Biology, Duncan Building, The University of Liverpool, Liverpool, UK;Department of Clinical Infection, Microbiology and Immunology, Duncan Building, The University of Liverpool, Liverpool, UK

关键词: Virus;    PCR;    Infection;    Cough;    Bronchoscopy;    Bronchoalveolar lavage;    Biopsy;   

Others  :  809292
DOI  :  10.1186/1745-9974-8-5

 received in 2012-05-15, accepted in 2012-09-07,  发布年份 2012

【 摘 要 】

Background

Viral respiratory tract infection is the most frequent cause of acute cough and is reported at onset in about one third of patients with chronic cough. Persistent infection is therefore one possible explanation for the cough reflex hypersensitivity and pulmonary inflammation reported in chronic cough patients.

Methods

Bronchoscopic endobronchial biopsies and bronchoalveolar lavage cell counts were obtained from ten healthy volunteers and twenty treatment resistant chronic cough patients (10 selected for lavage lymphocytosis). A screen for known respiratory pathogens was performed on biopsy tissue. Chronic cough patients also underwent cough reflex sensitivity testing using citric acid.

Results

There was no significant difference in incidence of infection between healthy volunteers and chronic cough patients (p = 0.115) or non-lymphocytic and lymphocytic groups (p = 0.404). BAL cell percentages were not significantly different between healthy volunteers and chronic cough patients without lymphocytosis. Lymphocytic patients however had a significantly raised percentage of lymphocytes (p < 0.01), neutrophils (p < 0.05), eosinophils (p < 0.05) and decreased macrophages (p < 0.001) verses healthy volunteers. There was no significant difference in the cough reflex sensitivity between non-lymphocytic and lymphocytic patients (p = 0.536).

Conclusions

This study indicates latent infection in the lung is unlikely to play an important role in chronic cough, but a role for undetected or undetectable pathogens in either the lung or a distal site could not be ruled out.

Trials registration

Current Controlled Trials ISRCTN62337037 & ISRCTN40147207

【 授权许可】

   
2012 West et al.; licensee BioMed Central Ltd.

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