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气道感染与囊性纤维化患儿的肺部疾病严重程度相关。

airway infection is associated with lung disease severity in children with cystic fibrosis.

作者信息

Marsac Charlotte, Berdah Laura, Thouvenin Guillaume, Sermet-Gaudelus Isabelle, Corvol Harriet

机构信息

Paediatric Pulmonology Dept and Cystic Fibrosis Centre, Sorbonne Université, Centre de Recherche Saint-Antoine, Inserm UMR_S938, AP-HP, Hôpital Trousseau, Paris, France.

Paediatric Pulmonology Dept and Cystic Fibrosis Centre, Université de Paris, Inserm U 1151, AP-HP, Hôpital Necker Enfants Malades, Paris, France.

出版信息

ERJ Open Res. 2021 May 31;7(2). doi: 10.1183/23120541.00076-2021. eCollection 2021 Apr.

Abstract

BACKGROUND

Despite the increasing prevalence of lung infection in patients with cystic fibrosis (CF), its clinical pathogenicity remains controversial. The objective of this study was to evaluate the effects of this emerging bacterium on lung disease severity in CF children.

METHODS

This case-control retrospective study took place in two French paediatric CF centres. 45 cases infected by were matched for age, sex, genotypes and pancreatic status to 45 never-infected controls. Clinical data were retrieved from clinical records over the 2 years before and after initial infection.

RESULTS

At infection onset, lung function was lower in cases compared with controls (p=0.006). Over the 2 years prior to acquisition, compared with controls, cases had more frequent pulmonary exacerbations (p=0.02), hospitalisations (p=0.05), and intravenous (p=0.03) and oral (p=0.001) antibiotic courses. In the 2 years following infection, cases remained more severe with more frequent pulmonary exacerbations (p=0.0001), hospitalisations (p=0.0001), and intravenous (p=0.0001) and oral antibiotic courses (p=0.0001). Lung function decline tended to be faster in cases (-5.5% per year) compared with controls (-0.5% per year).

CONCLUSIONS

This case-control study demonstrates that occurs more frequently in the patients with the worse lung disease. Further studies assessing the pathogenicity of this emerging pathogen and international treatment recommendations are warranted.

摘要

背景

尽管囊性纤维化(CF)患者肺部感染的患病率不断上升,但其临床致病性仍存在争议。本研究的目的是评估这种新出现的细菌对CF儿童肺部疾病严重程度的影响。

方法

这项病例对照回顾性研究在两个法国儿科CF中心进行。将45例感染[具体细菌名称未给出]的病例与45例未感染的对照进行年龄、性别、基因型和胰腺状态匹配。从初次感染前2年和感染后2年的临床记录中检索临床数据。

结果

在感染开始时,病例组的肺功能低于对照组(p = 0.006)。在感染前的2年中,与对照组相比,病例组肺部加重发作更频繁(p = 0.02)、住院次数更多(p = 0.05)、静脉使用抗生素疗程更多(p = 0.03)以及口服抗生素疗程更多(p = 0.001)。在感染后的2年中,病例组病情仍然更严重,肺部加重发作更频繁(p = 0.0001)、住院次数更多(p = 0.0001)、静脉使用抗生素疗程更多(p = 0.0001)以及口服抗生素疗程更多(p = 0.0001)。病例组的肺功能下降趋势比对照组更快(每年-5.5%)(对照组为每年-0.5%)。

结论

这项病例对照研究表明,[具体细菌名称未给出]在肺部疾病较差的患者中更频繁出现。有必要进一步开展研究以评估这种新出现病原体的致病性并制定国际治疗建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff0e/8165377/e038c1b85ea1/00076-2021.01.jpg

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