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Clinical outcomes after initial pseudomonas acquisition in cystic fibrosis

Edith T Zemanick1, Julia Emerson, Valeria Thompson

  • 1Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.

Pediatric Pulmonology
|March 20, 2014
PubMed

Insights

Newly acquired Pseudomonas aeruginosa (Pa) in cystic fibrosis (CF) patients did not impact lung function or growth. However, Pa acquisition increased pulmonary exacerbations and respiratory symptoms, suggesting a marker of disease severity.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Cystic Fibrosis Research

Background:

  • Pseudomonas aeruginosa (Pa) is a critical pathogen in cystic fibrosis (CF) affecting lung health.
  • Early eradication therapy is standard, but outcomes after initial Pa isolation require ongoing evaluation.
  • Understanding the impact of Pa acquisition is crucial for managing CF progression.

Purpose of the Study:

  • To assess clinical outcomes following initial Pseudomonas aeruginosa isolation in a U.S. pediatric CF cohort.
  • To evaluate the effect of Pa acquisition on lung function, growth, and exacerbations.
  • To determine associations between Pa acquisition and other respiratory pathogen co-infections.

Main Methods:

  • Analysis of data from the Early Pseudomonas Infection Control (EPIC) Observational Study.
  • Inclusion of pediatric CF patients with no prior Pa isolation.
  • Utilized population-averaged regression models (generalized estimating equations) to analyze outcomes.

Main Results:

  • No significant effect of Pa acquisition on lung function (FEV1 % predicted) or growth parameters.
  • Increased pulmonary exacerbation rate (IRR 1.40) and odds of crackles/wheeze (OR 1.23) post-Pa acquisition.
  • Increased odds of MRSA and S. maltophilia isolation, with decreased odds of H. influenzae.

Conclusions:

  • Initial Pseudomonas aeruginosa acquisition in CF patients was not linked to lung function or nutritional decline.
  • Pa acquisition correlated with a higher rate of pulmonary exacerbations and respiratory symptoms.
  • These findings suggest Pa acquisition may indicate more severe disease or contribute to exacerbations.
Abstract

Keywords:
P. aeruginosaclinical outcomescystic fibrosisepidemiologymicrobiologypulmonary exacerbations

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