Early acquisition of Pseudomonas aeruginosa in Mexican children with cystic fibrosis
Resumen
INTRODUCTION: Chronic infection with Pseudomonas aeruginosa (P. aeruginosa) is associated with a greater deterioration of pulmonary function, increase in hospitalizations and shorter survival in patients with cystic fibrosis.
OBJECTIVES: To evaluate the age of first detection of P. aeruginosa, effectiveness of the eradication treatment and prevalence of other pathogens in airway cultures.
MATERIALS AND METHODS: A cohort of patients with CF diagnosed within first year of life, who had follow-up at University Hospital was studied. Respiratory cultures were obtained quarterly. Patients with infection by P. aeruginosa received eradication treatment.
RESULTS: Thirty-five patients were included. During follow-up, 608 cultures were performed. In 34.7%, normal flora was detected, S. aureus 32.8%, P. aeruginosa 20.4%. Median age at first positive culture was 9 months. Eradication was achieved in 81.8%.
CONCLUSIONS: In this cohort of patients with cystic fibrosis, the acquisition of P. aeruginosa is earlier than in other groups reported in literature.
Citas
Salsgiver EL, Fink AK, Knapp EA, LiPuma JJ, Olivier KN, Marshall BC, et al. Changing Epidemiology of the Respiratory Bacteriology of Patients With Cystic Fibrosis. Chest. 2016 Feb;149(2):390-400. DOI: 10.1378/chest.15-0676
Pittman JE, Calloway EH, Kiser M, Yeatts J, Davis SD, Drumm ML, et al. Age of Pseudomonas aeruginosa acquisition and subsequent severity of cystic fibrosis lung disease. Pediatr Pulmonol. 2011 May;46(5):497-504. DOI: 10.1002/ppul.21397
Li Z, Kosorok MR, Farrell PM, Laxova A, West SE, Green CG, et al. Longitudinal development of mucoid Pseudomonas aeruginosa infection and lung disease progression in children with cystic fibrosis. JAMA. 2005 Feb 2;293(5):581-8. DOI: 10.1001/jama.293.5.581
Lahiri T, Hempstead SE, Brady C, Cannon CL, Clark K, Condren ME, et al. Clinical Practice Guidelines From the Cystic Fibrosis Foundation for Preschoolers With Cystic Fibrosis. Pediatrics. 2016 Apr;137(4). DOI: 10.1542/peds.2015-1784
Farrell PM, White TB, Ren CL, Hempstead SE, Accurso F, Derichs N, et al. Diagnosis of Cystic Fibrosis: Consensus Guidelines from the Cystic Fibrosis Foundation. J Pediatr. 2017 Feb;181S:S4-S15 e1. DOI: 10.1016/j.jpeds.2016.09.064
Lopez-Romo H. Los niveles socioeconomicos y la distribuciòn del gasto. 2009 [consultado; Disponible en: www.amai.org/NSE/NivelSocioeconomicoANAI,pdf.
Burns JL, Gibson RL, McNamara S, Yim D, Emerson J, Rosenfeld M, et al. Longitudinal assessment of Pseudomonas aeruginosa in young children with cystic fibrosis. J Infect Dis. 2001 Feb 1;183(3):444-52. DOI: 10.1086/318075
Maselli JH, Sontag MK, Norris JM, MacKenzie T, Wagener JS, Accurso FJ. Risk factors for initial acquisition of Pseudomonas aeruginosa in children with cystic fibrosis identified by newborn screening. Pediatr Pulmonol. 2003 Apr;35(4):257-62. DOI: 10.1002/ppul.10230
Rossi GA, Morelli P, Galietta LJ, Colin AA. Airway microenvironment alterations and pathogen growth in cystic fibrosis. Pediatr Pulmonol. 2019 Apr;54(4):497-506. DOI: 10.1002/ppul.10230
Abman SH, Ogle JW, Harbeck RJ, Butler-Simon N, Hammond KB, Accurso FJ. Early bacteriologic, immunologic, and clinical courses of young infants with cystic fibrosis identified by neonatal screening. J Pediatr. 1991 Aug;119(2):211-7. DOI: 10.1016/s0022-3476(05)80729-2
D'Alessandro V, Renteria F, Fernandez A, Martinez MI, Segal E. [Comparing the clinical-functional state in children with cystic fibrosis detected by neonatal screening or by clinical symptoms]. Arch Argent Pediatr. 2009 Oct;107(5):430-5. DOI: 10.1590/S0325-00752009000500010
Douglas TA, Brennan S, Gard S, Berry L, Gangell C, Stick SM, et al. Acquisition and eradication of P. aeruginosa in young children with cystic fibrosis. Eur Respir J. 2009 Feb;33(2):305-11. DOI: 10.1183/09031936.00043108.
Psoter KJ, De Roos AJ, Wakefield J, Mayer J, Rosenfeld M. Season is associated with Pseudomonas aeruginosa acquisition in young children with cystic fibrosis. Clin Microbiol Infect. 2013 Nov;19(11):E483-9. DOI: 10.1111/1469-0691.12272.
2019 [updated 05/05/2019; consultado; Disponible en: https://www.weather-mx.com/es/mexico/monterrey-clima.
Collaco JM, McGready J, Green DM, Naughton KM, Watson CP, Shields T, et al. Effect of temperature on cystic fibrosis lung disease and infections: a replicated cohort study. PLoS One. 2011;6(11):e27784. DOI: 10.1371/journal.pone.0027784
Sanchez-Dominguez CN, Reyes-Lopez MA, Bustamante A, Trevino V, Martinez-Rodriguez HG, Rojas-Martinez A, et al. Low-income status is an important risk factor in North East Mexican patients with cystic fibrosis. Rev Invest Clin. 2014 Mar-Apr;66(2):129-35.
Rho J, Ahn C, Gao A, Sawicki GS, Keller A, Jain R. Disparities in Mortality of Hispanic Patients with Cystic Fibrosis in the United States. A National and Regional Cohort Study. Am J Respir Crit Care Med. 2018 Oct 15;198(8):1055-63. DOI: 10.1164/rccm.201711-2357OC
Buu MC, Sanders LM, Mayo JA, Milla CE, Wise PH. Assessing Differences in Mortality Rates and Risk Factors Between Hispanic and Non-Hispanic Patients With Cystic Fibrosis in California. Chest. 2016 Feb;149(2):380-9. DOI: 10.1378/chest.14-2189
Psoter KJ, De Roos AJ, Mayer JD, Kaufman JD, Wakefield J, Rosenfeld M. Fine particulate matter exposure and initial Pseudomonas aeruginosa acquisition in cystic fibrosis. Ann Am Thorac Soc. 2015 Mar;12(3):385-91. DOI: 10.1513/AnnalsATS.201408-400OC