High viral frequency in children with gastroesophageal reflux-related chronic respiratory disorders

Introduction: In the pediatric population chronic respiratory disorders (CRDs) include many pathological entities in which gastroesophageal reflux (GER) may play a role in the induction or persistence of clinical symptoms. It is not well established whether infective agents may be present in lung aspiration. The aim of the work was to investigate whether different infective agents could be found in children with GER-related CRDs. Materials and Methods: Extensive microbiological investigations including culture for bacterial agents, serology, direct fluorescent antigen and polymerase chain reaction analyses for different respiratory viruses were performed in 32 children (118 males, 14 females, mean age 5.0 +/- 2.4 years). Fifteen children out of 32 considered as "aspirators" (lipid-laden macrophage index-LLMI->= 86 and pathological pH-assay) were compared to 17 "non-aspirators" (LLMI < 86 and normal pH-assay). Results: Aspirators were older (6.0 +/- 1.9 vs. 4.2 +/- 2.5 years, P = 0.006) and less frequently atopic (13% vs. 59%, P = 0.01) than non-aspirators. A high frequency of viral infections (20/32, 62.5%) was found, with frequent occurrence of multiple infections (10/20, 50%). Aspirators showed more frequent viral infections than non-aspirators (87% vs. 41%, P = 0.01). Rhinovirus and respiratory syncytial virus were the principal detected viruses in the aspirator group. Conclusions: Viral infections could play a key role in the pathogenesis of GER-related CRDs.