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Stenotrophomonas maltophilia: A marker of lung disease severity
Laura Berdah1, Jessica Taytard1, Sophie Leyronnas1
1APHP, Hôpital Trousseau, Cystic Fibrosis Center, Paris, France.
Background:
While the prevalence of Stenotrophomonas maltophilia lung infection in cystic fibrosis (CF) patients has increased in the last decades, its pathogenicity remains controversial. The aim of this study was to investigate the effects of S. maltophilia initial infection on the progression of lung disease in CF children.
Methods:
This case-control retrospective study took place in a pediatric CF center. A total of 23 cases defined by at least one sputum culture positive for S. maltophilia, were matched for age, sex, and CFTR mutations to 23 never infected CF controls. The clinical data were collected for 2 years before and after S. maltophilia initial infection and comprised lung function analyses, rates of exacerbations and of antibiotic courses.
Results:
Compared with controls, cases had lower lung function (P = 0.05), more frequent pulmonary exacerbations (P = 0.01), hospitalizations (P = 0.02), and intravenous antibiotic courses (P = 0.04) before S. maltophilia acquisition. In the year following S. maltophilia initial infection, lung function decline was similar in cases and controls but cases remained more severe, with more frequent pulmonary exacerbations (P = 0.01), hospitalizations (P = 0.02) and intravenous antibiotic courses (P = 0.02).
Conclusions:
S. maltophilia seems to be a marker of CF lung disease severity and international recommendations to reduce lung infection by this pathogen should rapidly emerge.
Insights
Stenotrophomonas maltophilia infection in cystic fibrosis (CF) patients indicates more severe lung disease. While not directly worsening lung function decline, it correlates with increased exacerbations and hospitalizations in CF children.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Cystic Fibrosis Research
Background:
- Increasing prevalence of Stenotrophomonas maltophilia lung infections in cystic fibrosis (CF) patients.
- Controversial pathogenicity of S. maltophilia in CF lung disease progression.
Purpose of the Study:
- To investigate the impact of initial S. maltophilia infection on lung disease progression in pediatric CF patients.
- To assess clinical outcomes in CF children following S. maltophilia acquisition.
Main Methods:
- Retrospective case-control study in a pediatric CF center.
- Matching 23 S. maltophilia-infected CF cases with 23 uninfected CF controls by age, sex, and CFTR mutations.
- Collecting clinical data for two years pre- and post-infection, including lung function, exacerbations, and antibiotic courses.
Main Results:
- CF patients with S. maltophilia showed lower lung function and more frequent exacerbations, hospitalizations, and antibiotic courses prior to infection acquisition.
- Post-infection, lung function decline was similar between groups, but S. maltophilia cases experienced more frequent exacerbations, hospitalizations, and antibiotic courses.
Conclusions:
- S. maltophilia infection appears to be a marker of CF lung disease severity.
- Urgent development of international recommendations to reduce S. maltophilia lung infections in CF patients is warranted.
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