Bronchoalveolar Interleukin-1 Beta: A Marker of Bacterial Burden in Critcally Ill Children with Nosocomial Pneumonia

Abstract

Objective: To assess the relationship between concentrations of bronchoalveolar cytokines and bacterial burden in critically ill children with a presumptive diagnosis of nosocomial pneumonia.Patients: According to the time course of nosocomial pneumonia at the time of study with bronchoalveolar lavage, 62 critically ill children with nosocomial pneumoniaInterventions: According to the time course of ventilator-associated pneumonia at the time of study with bronchoalveolar lavage, 62 children were divided into two subgroups: referral (n=32), and treated (n=30) nosocomial pneumonia. Bronchoalveolar lavage was performed in the most abnormal area on chest radiograph by fiberoptic bronchoscope. The concentrations of bronchoalveolar lavage cytokines.Measurement and main Results: 34 patients had a positive bacterial culture (bronchoalveolar lavage > or = 10 colony-forming units/mL), and made up 82% of pathogens recovered at high concentrations. The concentrations of bronchoalveolar lavage interleukin-1 beta were 204.2 +/− 15.7 and 38.2 +/− 12.6 pg/mL (mean +/− se) in the children with positive and negative bacterial culture, respectively (p < .001). Bronchoalveolar lavage interleukin- 1 beta was significantly higher in the children with a high bacterial burden (p < 0.001), with mixed bacterial infection (p < 0.001), and with nosocomial pneumonia (p < 0.001), compared with values in patients without these features.Conclusions: Since the concentration of bronchoalveolar lavage interleukin-1 beta was correlated with bacterial burden in the alveoli, it may be a marker for progressive and ongoing inflammation in critically ill children.