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Randomized Controlled Trial
. 2015 May;14(3):361-9.
doi: 10.1016/j.jcf.2014.12.007. Epub 2015 Jan 3.

Pseudomonas aeruginosa genotypes acquired by children with cystic fibrosis by age 5-years

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Free article
Randomized Controlled Trial

Pseudomonas aeruginosa genotypes acquired by children with cystic fibrosis by age 5-years

Timothy J Kidd et al. J Cyst Fibros. 2015 May.
Free article

Abstract

Background: We describe Pseudomonas aeruginosa acquisitions in children with cystic fibrosis (CF) aged ≤5-years, eradication treatment efficacy, and genotypic relationships between upper and lower airway isolates and strains from non-CF sources.

Methods: Of 168 CF children aged ≤5-years in a bronchoalveolar lavage (BAL)-directed therapy trial, 155 had detailed microbiological results. Overall, 201/271 (74%) P. aeruginosa isolates from BAL and oropharyngeal cultures were available for genotyping, including those collected before and after eradication therapy.

Results: Eighty-two (53%) subjects acquired P. aeruginosa, of which most were unique strains. Initial eradication success rate was 90%, but 36 (44%) reacquired P. aeruginosa, with genotypic substitutions more common in BAL (12/14) than oropharyngeal (3/11) cultures. Moreover, oropharyngeal cultures did not predict BAL genotypes reliably.

Conclusions: CF children acquire environmental P. aeruginosa strains frequently. However, discordance between BAL and oropharyngeal strains raises questions over upper airway reservoirs and how to best determine eradication in non-expectorating children.

Keywords: Cystic fibrosis; Eradication; Genotyping; Infection; Pseudomonas aeruginosa.

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