Pediatric Pulmonary Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Medical School, Hebrew University, Jerusalem, Israel.
Respir Med. 2017 Oct;131:241-246. doi: 10.1016/j.rmed.2017.08.028. Epub 2017 Sep 1.
Airway infections in Primary Ciliary Dyskinesia (PCD) are caused by different microorganisms, including pseudomonas aeruginosa (PA). The aim of this study was to investigate the association of PA colonization and the progression of lung disease in PCD.
Data from 11PCD centers were retrospectively collected from 2008 to 2013. Patients were considered colonized if PA grew on at least two separate sputum cultures; otherwise, they were classified as non-colonized. These two groups were compared on the lung function computed tomography (CT) Brody score and other clinical parameters.
Data were available from 217 patients; 60 (27.6%) of whom were assigned to the colonized group. Patients colonized with PA were older and were diagnosed at a later age. Baseline forced expiratory volume at 1 s (FEV) was lower in the colonized group (72.4 ± 22.0 vs. 80.1 ± 18.9, % predicted, p = 0.015), but FEV declined throughout the study period was similar in both groups. The colonized group had significantly worse CT-Brody scores (36.07 ± 24.38 vs. 25.56 ± 24.2, p = 0.034). A subgroup analysis with more stringent definitions of colonization revealed similar results.
Lung PA colonization in PCD is associated with more severe disease as shown by the FEV and CT score. However, the magnitude of decline in pulmonary function was similar in colonized and non-colonized PCD patients.
原发性纤毛运动障碍(PCD)中的气道感染由不同的微生物引起,包括铜绿假单胞菌(PA)。本研究旨在探讨 PA 定植与 PCD 肺部疾病进展的关系。
回顾性收集 2008 年至 2013 年来自 11 个 PCD 中心的数据。如果 PA 在至少两次独立的痰培养中生长,则认为患者定植;否则,将其归类为未定植。比较这两组患者的肺功能 CT(Brody 评分)和其他临床参数。
共有 217 名患者的数据可用;其中 60 名(27.6%)被分配到定植组。PA 定植的患者年龄更大,诊断年龄也更大。定植组患者的基线 1 秒用力呼气量(FEV)较低(72.4±22.0 与 80.1±18.9,预测值,p=0.015),但两组在整个研究期间 FEV 下降情况相似。定植组的 CT-Brody 评分明显更差(36.07±24.38 与 25.56±24.2,p=0.034)。使用更严格的定植定义进行亚组分析,结果相似。
PCD 中肺部 PA 定植与更严重的疾病有关,表现在 FEV 和 CT 评分上。然而,定植和非定植 PCD 患者的肺功能下降幅度相似。