Prognostic implications of initial oropharyngeal bacterial flora in patients with cystic fibrosis diagnosed before the age of two years

Valera L Hudson, Catherine L. Wielinski, Warren E. Regelmann

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Abstract

To evaluate the significance of early bacteriologic findings in infants and younger children with cystic fibrosis, we divided patients identified at ≤2 years of age into groups by initial oropharyngeal culture: group NF, normal respiratory flora (n = 17); group SA, Staphylococcus aureus without Pseudomonas aeruginosa (n = 20); group PA, P. aeruginosa without S. aureus (n = 6); group PA/SA, P. aeruginosa and S. aureus (n = 7); and group O, other potentially pathogenic bacteria (n = 31). Follow-up of patients ranged in age from 5.4 to 13 years. At diagnosis, group PA/SA had lower Brasfield scores (p <0.02) and higher γ-globu-lin levels (p <0.03) than the other groups. Five years after diagnosis, Brasfield scores were significantly lower in groups PA and PA/SA compared with the other groups; mean γ-globulin levels did not differ significantly among the groups. Groups PA and PA/SA also had evidence of significantly greater obstructive pulmonary disease by spirometry than groups NF and O. Group PA/SA had a 10-year survival estimate of 57%, significantly lower than the 92% to 100% estimates of the other four groups (p <0.0001). Thus P. aeruginosa in initial oropharyngeal cultures from patients ≤2 years of age with cystic fibrosis was associated with significantly increased morbidity, and the finding of P. aeruginosa and S. aureus together in initial oropharyngeal cultures with a significantly increased mortality rate during the first 10 years after diagnosis.

Original languageEnglish (US)
Pages (from-to)854-860
Number of pages7
JournalJournal of Pediatrics
Volume122
Issue number6
DOIs
StatePublished - Jan 1 1993

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Cystic Fibrosis
Pseudomonas aeruginosa
Staphylococcus aureus
Obstructive Lung Diseases
Spirometry
Globulins
Age Groups
Morbidity
Bacteria
Survival
Mortality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Prognostic implications of initial oropharyngeal bacterial flora in patients with cystic fibrosis diagnosed before the age of two years. / Hudson, Valera L; Wielinski, Catherine L.; Regelmann, Warren E.

In: Journal of Pediatrics, Vol. 122, No. 6, 01.01.1993, p. 854-860.

Research output: Contribution to journalArticle

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abstract = "To evaluate the significance of early bacteriologic findings in infants and younger children with cystic fibrosis, we divided patients identified at ≤2 years of age into groups by initial oropharyngeal culture: group NF, normal respiratory flora (n = 17); group SA, Staphylococcus aureus without Pseudomonas aeruginosa (n = 20); group PA, P. aeruginosa without S. aureus (n = 6); group PA/SA, P. aeruginosa and S. aureus (n = 7); and group O, other potentially pathogenic bacteria (n = 31). Follow-up of patients ranged in age from 5.4 to 13 years. At diagnosis, group PA/SA had lower Brasfield scores (p <0.02) and higher γ-globu-lin levels (p <0.03) than the other groups. Five years after diagnosis, Brasfield scores were significantly lower in groups PA and PA/SA compared with the other groups; mean γ-globulin levels did not differ significantly among the groups. Groups PA and PA/SA also had evidence of significantly greater obstructive pulmonary disease by spirometry than groups NF and O. Group PA/SA had a 10-year survival estimate of 57{\%}, significantly lower than the 92{\%} to 100{\%} estimates of the other four groups (p <0.0001). Thus P. aeruginosa in initial oropharyngeal cultures from patients ≤2 years of age with cystic fibrosis was associated with significantly increased morbidity, and the finding of P. aeruginosa and S. aureus together in initial oropharyngeal cultures with a significantly increased mortality rate during the first 10 years after diagnosis.",
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