Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Nov;18(6):844-850.
doi: 10.1016/j.jcf.2019.02.004. Epub 2019 Feb 27.

Early respiratory viral infections in infants with cystic fibrosis

Ashley R Deschamp  1 , Joseph E Hatch  2 , James E Slaven  3 , Netsanet Gebregziabher  3 , Gregory Storch  4 , Graham L Hall  5 , Stephen Stick  6 , Sarath Ranganathan  7 , Thomas W Ferkol  4 , Stephanie D Davis  2
Affiliations
Observational Study

Early respiratory viral infections in infants with cystic fibrosis

Ashley R Deschamp et al. J Cyst Fibros. 2019 Nov.

Abstract

Background: Viral infections contribute to morbidity in cystic fibrosis (CF), but the impact of respiratory viruses on the development of airway disease is poorly understood.

Methods: Infants with CF identified by newborn screening were enrolled prior to 4 months of age to participate in a prospective observational study at 4 centers. Clinical data were collected at clinic visits and weekly phone calls. Multiplex PCR assays were performed on nasopharyngeal swabs to detect respiratory viruses during routine visits and when symptomatic. Participants underwent bronchoscopy with bronchoalveolar lavage (BAL) and a subset underwent pulmonary function testing. We present findings through 8.5 months of life.

Results: Seventy infants were enrolled, mean age 3.1 ± 0.8 months. Rhinovirus was the most prevalent virus (66%), followed by parainfluenza (19%), and coronavirus (16%). Participants had a median of 1.5 viral positive swabs (range 0-10). Past viral infection was associated with elevated neutrophil concentrations and bacterial isolates in BAL fluid, including recovery of classic CF bacterial pathogens. When antibiotics were prescribed for respiratory-related indications, viruses were identified in 52% of those instances.

Conclusions: Early viral infections were associated with greater neutrophilic inflammation and bacterial pathogens. Early viral infections appear to contribute to initiation of lower airway inflammation in infants with CF. Antibiotics were commonly prescribed in the setting of a viral infection. Future investigations examining longitudinal relationships between viral infections, airway microbiome, and antibiotic use will allow us to elucidate the interplay between these factors in young children with CF.

Keywords: Bacteria; Cystic fibrosis; Inflammation; Pathogens; Viruses.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Inflammatory cells and soluble inflammatory markers in lavage fluid (BALF) collected from infants during the study period. Raw data is plotted and p-values <.05 are shown. Any virus (n = 22); Never virus (n = 44).
See this image and copyright information in PMC

References

    1. Rosenfeld M., Gibson R.L., McNamara S., Emerson J., Burns J.L., Castile R. Early pulmonary infection, inflammation and clinical outcomes in infants with cystic fibrosis. Pediatr Pulmonol. 2001;32:356–366. - PubMed
    1. Dakin C.J., Numa A.H., Wang H., Morton J.R., Vertzyas C.C., Henry R.L. Inflammation, infection, and pulmonary function in infants and young children with cystic fibrosis. Am J Respir Crit Care Med. 2002;165(7):904–910. - PubMed
    1. Armstrong D.S., Hook S.M., Jamsen K.M., Nixon G.M., Carzino R., Carlin J.B. Lower airway inflammation in infants with cystic fibrosis detected by newborn screening. Pediatr Pulmonol. 2005;40(6):500–510. - PubMed
    1. Sly P.D., Brennan S., Gangell C., de Klerk N., Murray C., Mott L. Lung disease at diagnosis in infants with cystic fibrosis detected by newborn screening. Am J Respir Crit Care Med. 2009;180(2):146–152. - PubMed
    1. van Ewijk B.E., van der Zalm M.M., Wolfs T.F., Fleer A., Kimpen J.L., Wilbrink B. Prevalence and impact of respiratory viral infections in young children with cystic fibrosis: prospective cohort study. Pediatrics. 2008;122(6):1171–1176. - PubMed

Publication types

Substances