Imaging Department, CF-Center, Clinical Investigation Centre, Pellegrin-Enfants Hospital, Bordeaux University Hospital, Bordeaux, France.
Laboratory of Cellular Respiratory Physiology, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, University Bordeaux Segalen, Bordeaux, France.
Pediatr Pulmonol. 2020 Oct;55(10):2641-2645. doi: 10.1002/ppul.24906. Epub 2020 Aug 4.
Bacterial infection early in life may increase structural lung lesions in children with cystic fibrosis (CF).
A 9-year monocentric (Bordeaux University Hospital, France) retrospective study in children with CF to evaluate the impact of the early-onset (at 1 year of age, Y1) of chronic meticillin-sensitive Staphylococcus aureus (MSSA) infection on the severity of bronchiectasis and Bhalla score on CT scan, clinical status, lung function tests, and serum immunoglobulins (IgG) at the age of 6 years (Y6).
A total of 37 children were included: 10 had contracted chronic MSSA infection at Y1 and 27 at a later date. Children with MSSA infection at Y1 showed increased Y6 CT scan bronchiectasis severity scores vs late MSSA infection (mean ± SD: 4.7 ± 0.8 vs 2.5 ± 0.5, P < .05) and Bhalla scores (7.3 ± 1.1 vs 4.7 ± 0.8, P < .05), but no significant decrease in lung function ([% reference values] FEV1: 83.7 ± 6 vs 90.6 ± 2.2, P = .21; FEF25-75: 67.8 ± 8.9 vs 76.3 ± 3.9, P = .18). In addition, Y6 serum IgG was greater in the early chronic Y1 MSSA group (11.3 ± 0.7 vs 8.9 ± 0.7 g/L, P < .05). Clinical symptoms or nutritional status were similar in both infection groups.
Early chronic MSSA infection may enhance the progression of structural lung disease in CF at 6 years.
生命早期的细菌感染可能会增加囊性纤维化(CF)患儿的结构性肺部病变。
这是一项为期 9 年的单中心回顾性研究(法国波尔多大学医院),纳入 CF 患儿,旨在评估 1 岁时(Y1)慢性耐甲氧西林金黄色葡萄球菌(MSSA)感染的早期发作对支气管扩张严重程度和 CT 扫描 Bhalla 评分、临床状态、肺功能检查以及 6 岁(Y6)时血清免疫球蛋白(IgG)的影响。
共纳入 37 名患儿:10 名患儿在 Y1 时患有慢性 MSSA 感染,27 名患儿在稍后时间患有慢性 MSSA 感染。与晚期 MSSA 感染相比,Y1 时患有 MSSA 感染的患儿 Y6 CT 扫描支气管扩张严重程度评分更高(平均±标准差:4.7±0.8 vs 2.5±0.5,P<.05)和 Bhalla 评分(7.3±1.1 vs 4.7±0.8,P<.05),但肺功能[(%参考值)FEV1:83.7±6 vs 90.6±2.2,P=.21;FEF25-75:67.8±8.9 vs 76.3±3.9,P=.18]无显著下降。此外,早期慢性 Y1 MSSA 组 Y6 血清 IgG 更高(11.3±0.7 vs 8.9±0.7 g/L,P<.05)。两组患儿的临床症状或营养状况相似。
早期慢性 MSSA 感染可能会加重 CF 患儿 6 岁时的结构性肺部疾病进展。