PT  - JOURNAL ARTICLE
AU  - J.P. Gutierrez
AU  - K. Grimwood
AU  - D.S. Armstrong
AU  - J.B. Carlin
AU  - R. Carzino
AU  - A. Olinsky
AU  - C.F. Robertson
AU  - P.D. Phelan
TI  - Interlobar differences in bronchoalveolar lavage fluid from children with cystic fibrosis
AID  - 10.1183/09031936.01.17202810
DP  - 2001 Feb 01
TA  - European Respiratory Journal
PG  - 281--286
VI  - 17
IP  - 2
4099  - http://erj.ersjournals.com/content/17/2/281.short
4100  - http://erj.ersjournals.com/content/17/2/281.full
SO  - Eur Respir J2001 Feb 01; 17
AB  - Bronchoalveolar lavage (BAL) performed in specialist centres has improved the understanding of infant cystic fibrosis (CF) lung disease. As most researchers sample from a single lobe, it was determined whether BAL results could be generalized to other lung segments.Thirty-three CF children, aged 1.5–57 months, underwent in random order sequential BAL of their right middle and lingula lobes. Specimens from each lobe had separate quantitative bacteriology, cytology and cytokine analysis.Bacterial counts ≥1×105 colony forming units (cfu)·mL−1 were observed in nine (27%) subjects, including six involving only the right middle lobe. These six children had similar inflammatory indices in their right middle and lingula lobes, and interleukin (IL)-8 concentrations in the latter were significantly higher than that observed within the lingula lobes of the 24 CF children with bacterial counts <1×105 cfu·mL−1. Lingula neutrophil and IL-8 levels correlated best with right middle lobe bacteria numbers.This observational study in cystic fibrosis children suggests that while inflammation is detected in both lungs, bacterial distribution may be more inhomogeneous. Bronchoalveolar lavage microbiological findings from a single lobe may therefore, not be generalized to other lung segments. When performing bronchoalveolar lavage in cystic fibrosis children, it is important to sample from multiple sites.This study was supported by grants from the Murdoch Children's Research Institute and the JB Were Charitable Fund, Melbourne, Australia.