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

Timothy J Kidd, Kay A Ramsay, Suzanna Vidmar, John B Carlin, Scott C Bell, Claire E Wainwright, Keith Grimwood, ACFBAL Study Investigators

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)361-369
Number of pages9
JournalJournal of Cystic Fibrosis
Volume14
Issue number3
Early online date03 Jan 2015
DOIs
Publication statusPublished - May 2015

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