Impact of isolation on the respiratory function of adult patients with cystic fibrosis.

BACKGROUND

The prevalence of lung isolation in cystic fibrosis (CF) patients has increased, but the impact on lung function is controversial. The aim of this study was to evaluate the long-term effects of isolation on respiratory function of adult patients with CF in the first 3 years after identification of isolation.

METHODS

This was a case-control retrospective study performed at a single CF centre in Lille, France. Data for 36 patients with CF who had at least one sputum culture positive for () were evaluated and compared with control CF patients uninfected by (). Respiratory function and exacerbation frequency were evaluated between 1 year prior to and 3 years after isolation.

RESULTS

Compared with the - group, the group had a lower forced expiratory volume in 1 s (FEV) at baseline (median (interquartile range): 55.2% (50.6-59.8%) 73.8% (67.2-80.4%); p=0.005), a greater decline in FEV (±se) in the first year after identification (-153.6±16.1 mL·year -63.8±18.5 mL·year; p=0.0003), and more exacerbations in the first 3 years after identification (9 (7-12) 7 (5-10); p=0.03). patients co-colonised with (n=27, 75%) had a greater FEV decline (p=0.003) and more exacerbations in the year after identification (p=0.037) compared with patients colonised with alone. Patients with chronic isolation (n=23, 64%) had more exacerbations than intermittently colonised patients in the 3 years after identification (p=0.012).

CONCLUSION

isolation is associated with a decline in respiratory function in patients with CF. Chronic isolation and co-isolation may be markers of more severe respiratory disease in + patients.