Background

Pediatric dysphagia is an increasing and serious problem, that around 1% of children in the general population are affected by. The prevalence is much higher in children with neuropediatric disorders. Besides the acute events, children with dysphagia are at greater risk for malnutrition, a delay in physical development and for recurrent respiratory infections leading to respiratory insufficiency. However, little is known about the processes taking place in the pediatric lung when food, drinks, saliva, or gastric acid are frequently aspirated.

Aims

We aimed to examine the inflammatory changes in the lung and the bloodwork of children affected from dysphagia compared to children without swallowing difficulties.

Methods

In a retrospective study, children whose bronchoalveolar lavage was collected via a bronchoscopy during 2012 and 2022, were analyzed. The BAL fluid (BALF) was tested for respiratory viruses and those causing atypical pneumonia and cultural cultivation was performed for bacteria including testing for antibiotic resistance. Additionally, the frequency of inflammatory cells in the blood and in the BALF were investigated.

Results

A total of 372 children with a mean age of 5.2 years had a complete medical record, of these 49 (13.2%) suffered from dysphagia. The remaining 323 (86.8%) served as a control cohort. Children suffering from dysphagia were more frequently colonised by pathological bacterial strains (54.3%) compared to the control cohort (37.3%), ?2(1)=4.859, p=0.027, ?=0.116. In the dysphagia group, the prevailing pathogens were H. influenza (6), S. pneumoniae (5) and P. aeruginosa (5).

Conclusion

Children suffering from dysphagia are more commonly colonized by respiratory pathogens.