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Clinical Course of Children with Chronic Suppurative Lung Disease or Bronchiectasis Infected with Pseudomonas

Elpiniki Kartsiouni1, Stylianos Chatzipanagiotou2, Angeliki Galani1

  • 1Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece.

Children (Basel, Switzerland)
|December 23, 2022
PubMed

Insights

In children with chronic suppurative lung disease (CSLD) or bronchiectasis, inhaled colistin improved clearance of Pseudomonas aeruginosa. Established bronchiectasis, however, was linked to slower clearance in this study.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Microbiology

Background:

  • Children without cystic fibrosis (non-CF) can develop chronic suppurative lung disease (CSLD) or bronchiectasis.
  • Pseudomonas aeruginosa (Pa) is a significant pathogen in these pediatric respiratory conditions.
  • Understanding the clinical course of Pa infection in these children is crucial for effective management.

Purpose of the Study:

  • To describe the clinical course of children with CSLD/bronchiectasis infected with Pa.
  • To identify factors influencing microbiological clearance in this patient group.

Main Methods:

  • Retrospective analysis of 54 children with CSLD/bronchiectasis and Pa infection.
  • Cox proportional hazard model used to assess predictors of microbiological clearance.
  • Covariates included age, bronchiectasis presence, inhaled colistin, azithromycin, and hypertonic saline.

Main Results:

  • Nebulised antibiotics (specifically inhaled colistin) were significant predictors of remission (HR: 3.99).
  • Established bronchiectasis was associated with a decreased rate of microbiological clearance (HR: 0.24).
  • Microbiological clearance required four months of no daily wet cough and four negative cultures.

Conclusions:

  • Inhaled colistin use is associated with an increased rate of microbiological clearance in children with Pa-infected CSLD/bronchiectasis.
  • Established bronchiectasis negatively impacts the rate of microbiological clearance.
  • Further research into optimizing treatment strategies for Pa in pediatric CSLD/bronchiectasis is warranted.

Keywords:
Pseudomonas aeruginosabronchiectasischildrenchronic suppurative lung disease

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