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Response to: Bacterial co-infection and the interpretation of immunological data from BAL fluid specimens in severe RSV bronchiolitis (Thorax 2006;61:1098)

Paediatric Intensive Care, Royal Liverpool Children’s Hospital, Eaton Road, Liverpool L12 2AP, UK; kent.thorburn@rlc.nhs.uk

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Eisenhut expresses a valid consideration that pertains to many of the studies investigating inflammatory mediators in respiratory syncytial virus (RSV) bronchiolitis. Many RSV immunopathogenesis studies presume a pure RSV aetiology. Co-infection (viral and/or bacterial) in severe bronchiolitis is not uncommon.^1,2,3 A phagocytic (neutrophils and macrophages) and natural kill cell response is common to both viral and bacterial lower respiratory infections.^4,5

Analysis of the blood differential leucocyte counts in our study group failed to discriminate between the RSV-only and bacterial co-infection groups (Mann–Whitney–Wilcoxon test: neutrophils p = 0.2; lymphocytes p = 0.2; monocytes p = 0.9), as did the C-reactive protein (p = 0.9).³ However, we only evaluated total number of leucocytes/white cells, bacterial growth density and microorganism species in the broncho-alveolar lavages, and not white cell type. Therefore we are unable to comment on potential differences in concentrations of lower respiratory tract neutrophils and alveolar macrophages between the groups.

The . . . [Full text of this article]

Relevant Article

Bacterial co-infection and interpretation of immunological data from BAL fluid specimens in severe RSV bronchiolitis

M Eisenhut
Thorax 2006 61: 1098. [Extract] [Full Text] [PDF]

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