Incident Stenotrophomonas maltophilia infection and lung function decline in cystic fibrosis
| Autor: | Kathryn A. Williams, Gregory P. Priebe, Emily E. Barsky, Gregory S. Sawicki |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Adolescent Cystic Fibrosis Stenotrophomonas maltophilia Cystic fibrosis Pulmonary function testing 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Forced Expiratory Volume medicine Humans 030212 general & internal medicine Respiratory system Child Lung function Retrospective Studies biology Respiratory tract infections business.industry Middle Aged medicine.disease biology.organism_classification Hospitalization Chronic infection 030228 respiratory system Pediatrics Perinatology and Child Health Immunology Cohort Female business Gram-Negative Bacterial Infections |
| Zdroj: | Pediatric pulmonology. 52(10) |
| ISSN: | 1099-0496 |
| Popis: | Objectives To determine whether incident detection of Stenotrophomonas maltophilia (SM) in patients with cystic fibrosis (CF) is associated with accelerated lung function decline and increased hospitalizations and to determine whether this effect is more pronounced in individuals with subsequent chronic infection. Methods We performed a longitudinal, retrospective single-center, pre-post study of 88 patients with CF, ages 6–51 years, with first positive respiratory culture for SM between 2008 and 2014. Rate of decline in FEV1 and hospitalization rates prior to and following incident SM infection were analyzed using segmented regression analysis of interrupted time series. Results Mean (SD) age was 17.4 (9.2) years and the mean (SD) FEV1 % predicted at acquisition was 90.0% (25.2). A total of 44% developed chronic SM infection. In regression analysis adjusted for clinical and demographic factors, there was worsening of the mean annual decline in FEV1 % predicted from −1.79 (95%CI: −2.43, −1.15) pre-acquisition to −2.14 (95%CI: −2.61, −1.67) post-acquisition (P = 0.005). A significant change was observed in those with either subsequent intermittent or chronic infection. The mean annual hospitalization rate increased significantly in the subgroup with chronic infection from 0.46 (95%CI: 0.33, 0.60) to 0.88 (95%CI: 0.68, 1.07) (P = 0.007). Conclusions In this single-center cohort, acquisition of SM in CF was associated with an acceleration in lung function decline. Among those with chronic colonization, acquisition was also associated with increased hospitalization rates. |
| Databáze: | OpenAIRE |
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