Aims:
  • 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.
Objectives:
  • To gain further understanding of the aetiology of bronchiectasis to influence the management of children with bronchiectasis.
Summary:

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.

Implications for policy and practice:

This study will contribute to our understanding of the aetiology of bronchiectasis and 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.
Chief Investigator:
Project Manager:
Contact information:
Funders:
  • National Health and Medical Research Council (NHMRC).
Collaborators:
  • Amanda Leach, Menzies School of Health Research
  • Anne Chang, Menzies School of Health Research and Queensland Children’s Medical Research Institute
  • Allen Cheng, Monash University and The Alfred Hospital
  • Malcolm McDonald, Menzies School of Health Research
  • Paul Torzillo, University of Sydney
  • Ngaire Brown, University of Wollongong (formerly Menzies School of Health Research).
     
  1. Hare, K.M., Marsh, R.L., Binks, M.J., Grimwood, K., Pizzutto, S.J., Leach, A.J., et al. (2013). Quantitative PCR confirms culture as the gold standard for the detection of lower airway infection by Haemophilus influenzae in Australian Indigenous children with bronchiectasis. Journal of Microbiological Methods, 92(3), 270-2.
  2. Hare, K.M., Leach, A.J., Morris, P.S., Smith-Vaughan, H.C., Torzillo, P., Bauert, P., et al. (2012). Impact of recent antibiotics upon nasopharyngeal carriage and lower airway infection in Indigenous Australian children with non-CF bronchiectasis. International Journal of Antimicrobial Agents, 40, 365-9.
  3. Hare, K.M., Binks, M.J., Grimwood, K., Chang, A.B., Leach, A.J., & Smith-Vaughan, H.C. (2012). Culture and PCR detection of Haemophilus influenzae and Haemophilus haemolyticus in Australian Indigenous children with bronchiectasis.Journal of Clinical Microbiology, 50(7), 2444-5.
  4. Hare, K.M., Smith-Vaughan, & H.C., Leach, A.J. (2011). Viability of respiratory pathogens cultured from nasopharyngeal swabs stored for up to 12 years at -70oC in skim milk tryptone glucose glycerol broth. Journal of Microbiological Methods, 86(3), 364-7.
  5. Hare, K.M., Smith-Vaughan, H.C., & Leach, A.J. (2010). The bacteriology of lower respiratory infections in Papua New Guinean and Australian Indigenous children. PNG Medical Journal, 53(3-4), 151-65.
  6. Hare, K.M., Grimwood, K., Leach, A.J., Smith-Vaughan, H., Torzillo, P., Morris, P.S., et al. (2010). Respiratory bacterial pathogens in the nasopharynx and lower airways of Australian Indigenous children with bronchiectasis. Journal of Pediatrics, 157(6), 1001-5.
  7. Hare, K.M., Stubbs, E., Beissbarth, J., Morris, P.S., Leach, A.J. (2010). Swab transport in Amies gel followed by frozen storage in skim milk tryptone glucose glycerol broth (STGGB) for studies of respiratory bacterial pathogens. Journal of Microbiological Methods, 81(3), 253-5.
  8. Hare, K.M., Smith-Vaughan, H., Binks, M., Park, I.H., Nahm, M.H., & Leach, A.J. (2009). "Dodgy 6As": differentiating pneumococcal serotype 6C from 6A by use of the Quellung reaction. Journal of Clinical Microbiology, 47(6), 1981-2.
  9. Hare, K.M., Morris, P., Smith-Vaughan, H., & Leach, A.J. (2008). Random colony selection versus colony morphology for detection of multiple pneumococcal serotypes in nasopharyngeal swabs. The Pediatric Infectious Disease Journal, 27(2), 178-80.