Early Pseudomonas aeruginosa predicts poorer pulmonary function in preschool children with cystic fibrosis.
J Cyst Fibros
; 21(6): 988-995, 2022 11.
Article
en En
| MEDLINE
| ID: mdl-35504829
ABSTRACT
BACKGROUND:
We previously reported relatively normal pulmonary function (2 years of age) and computed tomography (CT, 1 year of age) in cystic fibrosis (CF) newborn screened (NBS) infants. We now report follow up of these children to preschool age.METHODS:
67 NBS children with CF and 41 healthy controls underwent pulmonary function tests in infancy (â¼3 months, 1 year and 2 years) and at preschool (3-6 years). Broncho-alveolar lavage (BAL) and CT were undertaken in those with CF at 1 year. Primary outcomes at preschool were lung clearance index (LCI) and forced expired volume (FEV0.75). Risk factors for lung function impairment were identified by regression modelling, emphasising factors that could be identified or measured in the first 2 years of life.RESULTS:
At preschool age children with CF had poorer lung function than controls, mean(95% CI) difference in LCI z-score 1.47(0.96;1.97) and FEV0.75 z-score -0.54(-0.98; -0.10). Isolation of Pseudomonas aeruginosa before 6 months was a highly significant predictor of raised (abnormal) preschool LCI, associated with a mean (95%CI) increase of 1.69(0.43, 2.95) z-scores, compared to those with no Pseudomonas aeruginosa during the first 2 years of life. Including 2 year LCI and 1 year CT data in the predictive model increased the r2 from 13% to 61%.CONCLUSIONS:
Lung function deteriorates after 2 years in NBS children with CF. Isolation of Pseudomonas aeruginosa before 6 months and minor abnormalities of infant lung function tests and CT in infancy are associated with higher preschool LCI.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Fibrosis Quística
Tipo de estudio:
Diagnostic_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Child, preschool
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Humans
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Infant
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Newborn
Idioma:
En
Revista:
J Cyst Fibros
Año:
2022
Tipo del documento:
Article
País de afiliación:
Reino Unido