Your browser doesn't support javascript.
loading
The clinical significance of oropharyngeal cultures in young children with cystic fibrosis.
Breuer, Oded; Caudri, Daan; Akesson, Lauren; Ranganathan, Sarath; Stick, Stephen M; Schultz, André.
Afiliación
  • Breuer O; Telethon Kids Institute, University of Western Australia, Perth, Australia.
  • Caudri D; Princess Margaret Hospital for Children, Perth, Australia.
  • Akesson L; These authors contributed equally to this work.
  • Ranganathan S; Telethon Kids Institute, University of Western Australia, Perth, Australia.
  • Stick SM; Princess Margaret Hospital for Children, Perth, Australia.
  • Schultz A; Dept of Pediatrics/Respiratory Medicine, Erasmus MC, Rotterdam, The Netherlands.
Eur Respir J ; 51(5)2018 05.
Article en En | MEDLINE | ID: mdl-29678944
ABSTRACT
In children with cystic fibrosis (CF) the associations between oropharyngeal swabs (OPSs) for detection of Pseudomonas and lung disease have not been evaluated.OPS and bronchoalveolar lavage (BAL) samples were obtained annually in children with CF from 2005 to 2017. OPS test characteristics were calculated using BAL as "gold standard". Results were related to lung inflammation (BAL neutrophil elastase and interleukin-8), structural lung disease (chest computed tomography PRAGMA-CF (Perth-Rotterdam Annotated Grid Morphometric Analysis for CF) scores), respiratory exacerbations and future detection of Pseudomonas on BAL.From 181 patients, 690 paired OPS-BAL cultures were obtained. Prevalence of Pseudomonas in BAL was 7.4%. OPS sensitivity was 23.0% and specificity was 91.4%, reducing the post-test probability for a positive BAL following a negative OPS to 6.3%. Pseudomonas on OPS was not associated with lung inflammation or respiratory exacerbations, but was weakly associated with current PRAGMA-CF %Disease score (p=0.043). Pseudomonas on BAL was associated with positive neutrophil elastase (OR 4.17, 95% CI 2.04-8.53; p<0.001), increased interleukin-8 (p<0.001), increased all baseline PRAGMA computed tomography scores (p<0.001), progression of PRAGMA computed tomography scores (p<0.05) and increased risk of respiratory exacerbations (incidence rate ratio 2.11, 95% CI 1.15-3.87; p=0.017).In children with CF OPSs only marginally change the probability of detecting lower airway Pseudomonas and are not associated with lung disease indices nor exacerbations risk.
Asunto(s)

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Orofaringe / Pseudomonas aeruginosa / Infecciones por Pseudomonas / Biomarcadores / Fibrosis Quística Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Oceania Idioma: En Revista: Eur Respir J Año: 2018 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Orofaringe / Pseudomonas aeruginosa / Infecciones por Pseudomonas / Biomarcadores / Fibrosis Quística Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Oceania Idioma: En Revista: Eur Respir J Año: 2018 Tipo del documento: Article País de afiliación: Australia