Impact of Pseudomonas and Staphylococcus infection on inflammation and clinical status in young children with cystic fibrosis.
J Pediatr
; 154(2): 183-8, 2009 Feb.
Article
en En
| MEDLINE
| ID: mdl-18822427
ABSTRACT
OBJECTIVE:
To assess the effects of Pseudomonas aeruginosa and Staphylococcus aureus infection on lower airway inflammation and clinical status in young children with cystic fibrosis (CF). STUDYDESIGN:
We studied 111 children age < 6 years who had 2 P aeruginosa-positive oropharyngeal cultures within 12 months. We examined bronchoalveolar lavage fluid (BALF) inflammatory markers (ie, cell count, differential, interleukin [IL]-8, IL-6, neutrophil elastase), CF-related bacterial pathogens, exotoxin A serology, and clinical indicators of disease severity.RESULTS:
Young children with CF with both upper and lower airway P aeruginosa infection had higher neutrophil counts, higher IL-8 and free neutrophil elastase levels, increased likelihood of positive exotoxin A titers, and lower Shwachman scores compared with those with positive upper airway cultures only. S aureus was associated with increased lower airway inflammation, and the presence of both P aeruginosa and S aureus had an additive effect on concentrations of lower airway inflammatory markers. BALF markers of inflammation were increased with the number of different bacterial pathogens detected.CONCLUSIONS:
Young children with CF who have upper and lower airway P aeruginosa infection have increased endobronchial inflammation and poorer clinical status compared with those with only upper airway P aeruginosa infection. The independent and additive effects of S aureus on inflammation support the significance of polymicrobial infection in early CF lung disease.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Infecciones por Pseudomonas
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Infecciones Estafilocócicas
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Líquido del Lavado Bronquioalveolar
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Fibrosis Quística
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Inflamación
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Pulmón
Tipo de estudio:
Observational_studies
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Prevalence_studies
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Risk_factors_studies
Límite:
Child, preschool
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Female
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Humans
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Male
Idioma:
En
Revista:
J Pediatr
Año:
2009
Tipo del documento:
Article
País de afiliación:
Estados Unidos