Predictors of mucoid Pseudomonas colonization in cystic fibrosis patients

Hara Levy, Leslie A. Kalish, Carolyn L. Cannon, K. Christopher García, Craig Gerard, Don Goldmann, Gerald B. Pier, Scott T. Weiss, Andrew Colin

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Rationale: Chronic mucoid Pseudomonas aeruginosa within the airway in cystic fibrosis (CF) patients can determine prognosis. Understanding the risk factors of mucoid P. aeruginosa acquisition may change how we deliver care. This study aims to evaluate whether presence of risk factors reported to predict disease severity including gender, CFTR genotype, bacterial organisms in airway cultures, and serum levels of vitamins A and E, albumin, C-reactive protein, alpha 1-antitrypsin, and immunoglobulins increased the risk of mucoid P. aeruginosa acquisition. Methods: Primary endpoint was age at first transition from negative to positive culture for mucoid P. aeruginosa. Cox proportional hazards regression with time-dependent covariates examined development of mucoid P. aeruginosa infection and its association with longitudinally measured serum biomarkers, pulmonary function, and culture results for other organisms. Results: Median ages at CF diagnosis and at first culture were 0.55 and 5.7 years, respectively. Median number of cultures/patient was 17. Of the 323 subjects, 150 developed mucoid P. aeruginosa during a median 8.1 years' follow-up. In multivariate analysis, gender (relative hazard [RH] 0.55 for male vs. female, P = 0.001), number of DF508 alleles (RH 1.66 for 1 or 2 vs. 0, P = 0.04), FEV1 % (RH 1.16 for 10% decrease, P = 0.008), and most recent Staphylococcus aureus status (RH 0.24 for positive vs. negative, P < 0.0001) remained statistically significant. Conclusion: Female gender, number of DF508 alleles, decreased lung function, and lack of S. aureus on recent sputum culture are important risk factors for early detection of mucoid P. aeruginosa.

Original languageEnglish
Pages (from-to)463-471
Number of pages9
JournalPediatric Pulmonology
Volume43
Issue number5
DOIs
StatePublished - May 1 2008

Fingerprint

Pseudomonas
Cystic Fibrosis
Pseudomonas aeruginosa
Staphylococcus aureus
Alleles
Pseudomonas Infections
Lung
alpha 1-Antitrypsin
Sputum
Serum
Vitamin A
Vitamin E
C-Reactive Protein
Immunoglobulins
Albumins
Multivariate Analysis
Biomarkers
Genotype

Keywords

  • Cystic fibrosis
  • Pseudomonas colonization

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Levy, H., Kalish, L. A., Cannon, C. L., García, K. C., Gerard, C., Goldmann, D., ... Colin, A. (2008). Predictors of mucoid Pseudomonas colonization in cystic fibrosis patients. Pediatric Pulmonology, 43(5), 463-471. https://doi.org/10.1002/ppul.20794

Predictors of mucoid Pseudomonas colonization in cystic fibrosis patients. / Levy, Hara; Kalish, Leslie A.; Cannon, Carolyn L.; García, K. Christopher; Gerard, Craig; Goldmann, Don; Pier, Gerald B.; Weiss, Scott T.; Colin, Andrew.

In: Pediatric Pulmonology, Vol. 43, No. 5, 01.05.2008, p. 463-471.

Research output: Contribution to journalArticle

Levy, H, Kalish, LA, Cannon, CL, García, KC, Gerard, C, Goldmann, D, Pier, GB, Weiss, ST & Colin, A 2008, 'Predictors of mucoid Pseudomonas colonization in cystic fibrosis patients', Pediatric Pulmonology, vol. 43, no. 5, pp. 463-471. https://doi.org/10.1002/ppul.20794
Levy H, Kalish LA, Cannon CL, García KC, Gerard C, Goldmann D et al. Predictors of mucoid Pseudomonas colonization in cystic fibrosis patients. Pediatric Pulmonology. 2008 May 1;43(5):463-471. https://doi.org/10.1002/ppul.20794
Levy, Hara ; Kalish, Leslie A. ; Cannon, Carolyn L. ; García, K. Christopher ; Gerard, Craig ; Goldmann, Don ; Pier, Gerald B. ; Weiss, Scott T. ; Colin, Andrew. / Predictors of mucoid Pseudomonas colonization in cystic fibrosis patients. In: Pediatric Pulmonology. 2008 ; Vol. 43, No. 5. pp. 463-471.
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abstract = "Rationale: Chronic mucoid Pseudomonas aeruginosa within the airway in cystic fibrosis (CF) patients can determine prognosis. Understanding the risk factors of mucoid P. aeruginosa acquisition may change how we deliver care. This study aims to evaluate whether presence of risk factors reported to predict disease severity including gender, CFTR genotype, bacterial organisms in airway cultures, and serum levels of vitamins A and E, albumin, C-reactive protein, alpha 1-antitrypsin, and immunoglobulins increased the risk of mucoid P. aeruginosa acquisition. Methods: Primary endpoint was age at first transition from negative to positive culture for mucoid P. aeruginosa. Cox proportional hazards regression with time-dependent covariates examined development of mucoid P. aeruginosa infection and its association with longitudinally measured serum biomarkers, pulmonary function, and culture results for other organisms. Results: Median ages at CF diagnosis and at first culture were 0.55 and 5.7 years, respectively. Median number of cultures/patient was 17. Of the 323 subjects, 150 developed mucoid P. aeruginosa during a median 8.1 years' follow-up. In multivariate analysis, gender (relative hazard [RH] 0.55 for male vs. female, P = 0.001), number of DF508 alleles (RH 1.66 for 1 or 2 vs. 0, P = 0.04), FEV1 {\%} (RH 1.16 for 10{\%} decrease, P = 0.008), and most recent Staphylococcus aureus status (RH 0.24 for positive vs. negative, P < 0.0001) remained statistically significant. Conclusion: Female gender, number of DF508 alleles, decreased lung function, and lack of S. aureus on recent sputum culture are important risk factors for early detection of mucoid P. aeruginosa.",
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