Department of Respiratory Disease, University Hospital of Leuven, Belgium.
Center for Environmental Sciences, Hasselt University, Hasselt, Belgium; Centre for Environment and health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
J Cyst Fibros. 2015 Nov;14(6):741-7. doi: 10.1016/j.jcf.2015.04.004. Epub 2015 May 2.
The acquisition of Pseudomonas aeruginosa in cystic fibrosis (CF) is associated with lower survival, decreased lung function, worse radiological scores, increased exacerbations and reduced nutritional status. Open water is a known reservoir and a potential source of exposure to P. aeruginosa.
Twenty eight adult CF patients who had no history of P. aeruginosa and had negative P. aeruginosa IgG antibody levels, were matched by age and sex with 28 CF patients with chronic P. aeruginosa colonization. Straight line and closest walking distance from patient's residence to the nearest "blue space", i.e. surface water as determined by Google Earth, were compared between the two groups, and odds ratios (OR) were estimated using conditional logistic regression.
Patients who were never infected with P. aeruginosa lived significantly further away from a natural water source than P. aeruginosa colonized patients, both when considering shortest walking distance (mean 487 m vs 308 m, p=0.014) and beeline (mean 324 m vs 202 m, p=0.021). Conditional logistic regression (correcting for FEV1%) revealed ORs for chronic P. aeruginosa colonization of 0.35 (95% CI 0.13-0.98; p=0.045) and 0.12 (95% CI 0.02-0.81; p=0.028) for each doubling in the beeline or walking distance, respectively, between residence and open water.
We discovered that adult CF patients without P. aeruginosa infection live significantly further from blue space than CF patients with chronic P. aeruginosa colonization. Within the limitations of a case-control study, this may indicate that natural open water represents a source of infection by P. aeruginosa in CF.
The study was approved by the local ethical committee of the UZ Leuven, Belgium (ML-5028).
铜绿假单胞菌在囊性纤维化（CF）中的获得与生存率降低、肺功能下降、影像学评分恶化、恶化次数增加和营养状况下降有关。露天水源是已知的储水池，也是铜绿假单胞菌暴露的潜在来源。
选择 28 例无铜绿假单胞菌病史且铜绿假单胞菌 IgG 抗体水平阴性的成年 CF 患者，按年龄和性别与 28 例慢性铜绿假单胞菌定植的 CF 患者相匹配。比较两组患者居住地到最近“蓝色空间”（即通过谷歌地球确定的地表水）的直线和最短步行距离，并用条件逻辑回归估计比值比（OR）。
从未感染过铜绿假单胞菌的患者与定植铜绿假单胞菌的患者相比，居住在天然水源的距离明显更远，无论是考虑最短步行距离（平均值分别为 487m 和 308m，p=0.014）还是直线距离（平均值分别为 324m 和 202m，p=0.021）。条件逻辑回归（校正 FEV1%）显示，慢性铜绿假单胞菌定植的 OR 分别为 0.35（95%CI 0.13-0.98；p=0.045）和 0.12（95%CI 0.02-0.81；p=0.028），居住地点与露天水源之间的直线或步行距离每增加一倍。
我们发现，无铜绿假单胞菌感染的成年 CF 患者与慢性铜绿假单胞菌定植的 CF 患者相比，居住在露天水源的距离明显更远。在病例对照研究的限制范围内，这可能表明天然露天水源是 CF 中铜绿假单胞菌感染的来源。
该研究得到了比利时鲁汶大学医学伦理委员会（ML-5028）的批准。
