78 Differences in infection, inflammation and structural abnormalities between the right and left lung

Abstract

Background Previous studies, albeit small sample sizes have shown early infection in young children with cystic fibrosis (CF) can be detected in bronchoalveolar lavage (BAL) samples on one side despite inflammation being present on both sides of the lung. Aim To investigate differences between the right and left lung in terms of infection, inflammation and lung structure using microbiological culture taken from the right and left lobes of BAL samples of children. Methods Microbiological culture data were collected from BAL samples of the right and left lobes from children with CF. Samples were analysed using routine microbiological processing procedures at The Royal Children's Hospital, Melbourne. Respective Chest Computed Tomography (CT) images were analysed using the Brody scoring system and all lung lobes were assessed. Results Data from 527 BAL samples from 124 children were analysed. Neutrophil elastase (ne) was detected and reported in 163 (31%) of samples and interleukin-8 (IL-8) measured in 519 (98%). Mean (SD) ne reported was 2654.08 (7249.51) mg/ml, and mean (SD) IL8 measured 3.24 (7.65)ng/ml. A difference between presence of infection in the right and left lung existed (p 2 (1) = 188.72; p 2 (1) = 56.23; p Pseudomonas aeruginosa infection was not present on the left side [χ 2 (1) = 4.72; p Conclusion Lower respiratory infection and early lung structural changes appeared to be more common in the left lung in infants and young children with CF.