囊性纤维化气道中的纵向细菌流行情况：事实与假象
Longitudinal bacterial prevalence in cystic fibrosis airways: Fact and artifact.
作者信息
VanDevanter D R, LiPuma J J, Konstan M W
机构信息
Case Western Reserve University School of Medicine, Cleveland OH USA.
University of Michigan, Ann Arbor, MI USA.
出版信息
J Cyst Fibros. 2024 Jan;23(1):58-64. doi: 10.1016/j.jcf.2023.09.011. Epub 2023 Oct 1.
BACKGROUND
Opportunistic bacterial infection is a hallmark of cystic fibrosis (CF) lung disease and early mortality. Poorly characterized prevalence changes have accompanied two decades of health improvements, with CFTR modulators likely to further affect infection epidemiology.
METHODS
Bacterial prevalence change trends across birth cohorts were assessed with linear regression using 2001-2019 US CF Foundation Patient Registry data. Informative missingness was assessed, as was age-to-age infection status.
RESULTS
Bacterial prevalence constantly changed from 2001 to 2019, with changes differing across birth cohorts. Informative censoring affected prevalence change for some organisms. Age-to-age infection status changes were greater than net changes in bacterial prevalence and varied by age.
CONCLUSIONS
CF infection epidemiology changed over two decades and will continue to do so. Understanding how modulators affect infection epidemiology will require creative designs for longitudinal prevalence change studies emphasizing prevalence changes independent of effects on lung biology.
背景
机会性细菌感染是囊性纤维化（CF）肺部疾病和早期死亡的一个标志。在过去二十年健康状况改善的同时，患病率变化情况却鲜有明确描述，而CFTR调节剂可能会进一步影响感染流行病学。
方法
利用2001 - 2019年美国囊性纤维化基金会患者登记数据，通过线性回归评估不同出生队列中细菌患病率的变化趋势。评估了信息缺失情况以及不同年龄段的感染状态。
结果
2001年至2019年期间细菌患病率不断变化，不同出生队列的变化有所不同。信息删失影响了某些微生物的患病率变化。不同年龄段的感染状态变化大于细菌患病率的净变化，且因年龄而异。
结论
CF感染流行病学在二十年间发生了变化，并且还将继续变化。要了解调节剂如何影响感染流行病学，需要针对纵向患病率变化研究进行创新性设计，强调患病率变化独立于对肺部生物学的影响。
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