Pseudomonas aeruginosa genotypes acquired by children with cystic fibrosis by age 5-years.

作者信息

Kidd Timothy J, Ramsay Kay A, Vidmar Suzanna, Carlin John B, Bell Scott C, Wainwright Claire E, Grimwood Keith

机构信息

Queensland Children's Medical Research Institute, Royal Children's Hospital, The University of Queensland, Herston, QLD 4029, Australia.

出版信息

J Cyst Fibros. 2015 May;14(3):361-9. doi: 10.1016/j.jcf.2014.12.007. Epub 2015 Jan 3.

DOI:10.1016/j.jcf.2014.12.007

PMID:25563522

Abstract

BACKGROUND

We describe Pseudomonas aeruginosa acquisitions in children with cystic fibrosis (CF) aged ≤5-years, eradication treatment efficacy, and genotypic relationships between upper and lower airway isolates and strains from non-CF sources.

METHODS

Of 168 CF children aged ≤5-years in a bronchoalveolar lavage (BAL)-directed therapy trial, 155 had detailed microbiological results. Overall, 201/271 (74%) P. aeruginosa isolates from BAL and oropharyngeal cultures were available for genotyping, including those collected before and after eradication therapy.

RESULTS

Eighty-two (53%) subjects acquired P. aeruginosa, of which most were unique strains. Initial eradication success rate was 90%, but 36 (44%) reacquired P. aeruginosa, with genotypic substitutions more common in BAL (12/14) than oropharyngeal (3/11) cultures. Moreover, oropharyngeal cultures did not predict BAL genotypes reliably.

CONCLUSIONS

CF children acquire environmental P. aeruginosa strains frequently. However, discordance between BAL and oropharyngeal strains raises questions over upper airway reservoirs and how to best determine eradication in non-expectorating children.

摘要