TY - JOUR
T1 - Prognostic implications of initial oropharyngeal bacterial flora in patients with cystic fibrosis diagnosed before the age of two years
AU - Hudson, Valera L.
AU - Wielinski, Catherine L.
AU - Regelmann, Warren E.
N1 - Funding Information:
Supported by a fellowship training grant (Dr. Hudson) from the Cystic Fibrosis Foundation. National Institutes of Health (ROIHL27355), Submitted Reprint BG-240. Medical College of Georgia, Augusta, GA 309] 2-3755. Copyright 0022-3476/93/$1.00
Funding Information:
and a Cystic Fibrosis Foundation Center grant.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1993
Y1 - 1993
N2 - 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.
AB - 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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U2 - 10.1016/S0022-3476(09)90007-5
DO - 10.1016/S0022-3476(09)90007-5
M3 - Article
C2 - 8501559
AN - SCOPUS:0027195501
SN - 0022-3476
VL - 122
SP - 854
EP - 860
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 6
ER -