Bronchiectasis is a chronic lung disease thought to result from chronic inflammation of the lower respiratory tract as a result of recurrent respiratory tract infections early in life. The prevalence of bronchiectasis in NT children is disproportionately high compared with urban Australia.
- To test children undergoing bronchoscopy under anaesthetic for suspected Bronchiectasis (BE) to compare the bacteria found in the lung with bacteria found in the upper airway to better understand the bacterial causes of bronchiectasis in children. It will also investigate the antibiotic resistance of these organisms, particularly to azithromycin.
- To investigate the influence of long term azithromycin on nasopharyngeal respiratory bacteriology of Northern Territory (NT) children enrolled in the Multi-centre Bronchiectasis Study.
- To gain further understanding of the aetiology of bronchiectasis to influence the management of children with bronchiectasis.
Our research has found:
The dominant bacteria in both the upper and lower airways of Indigenous children are non-typable Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Children who received azithromycin had reduced carriage of these three main pathogens in the upper airways but increased carriage of Staphylococcus aureus (golden Staph) and bacteria resistant to the macrolide antibiotics.In contrast, only Moraxella catarrhalis carriage was reduced in the lower airways of children receiving azithromycin. The risk of lower airway infection by antibiotic resistant bacteria in children receiving antibiotics is of concern.