| Pseudomonas aeruginosa in children with cystic fibrosis diagnosed through newborn screening: assessment of clinic exposures and microbial genotypes. | |
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MedLine Citation:
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PMID: 20575089 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Chronic pulmonary infection with Pseudomonas aeruginosa (PA) is responsible for significant morbidity and mortality in cystic fibrosis (CF). Because of the limited studies evaluating early exposure and the progression of genetic variability of PA, our goal was to assess PA in young children with CF followed in two clinic types. METHODS: A total of 39 infants with CF diagnosed through newborn screening were randomly assigned to either a segregated (PA-free) or mixed (PA-positive) clinic at two different CF centers, one of which replaced an older, mixed clinic where nosocomial acquisition was suspected. Oropharyngeal (OP) swab cultures were examined with subsequent genotyping to characterize the strains of PA isolated. RESULTS: We found that 13/21 segregated clinic patients and 14/18 mixed clinic patients showed positive PA, with median acquisition ages of 3.3 and 2.2 years, respectively (P = 0.57). The median time to PA acquisition, however, was significantly longer in the new clinic with proper hygiene precautions compared to an old site (5.0 years vs. 1.7 years, P < 0.001). The majority of subjects isolated a single genotype of PA or AP-PCR types during the study period with eight subjects clearing the isolate after only one positive culture. The development of chronic colonization yielded the predominance of a single major genotype or AP-PCR type. CONCLUSIONS: Segregation of infants and young children with CF in PA-negative or PA-positive clinics did not alter the time to first PA isolation in this randomized assessment of facilities with hygienic precautions. During the early infection period where PA is first isolated in young children with CF, patients cleared different PA strains until a predominant strain established permanent colonization. |
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Authors:
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Don Hayes; Susan E West; Michael J Rock; Zhanhai Li; Mark L Splaingard; Philip M Farrell |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Pediatric pulmonology Volume: 45 ISSN: 1099-0496 ISO Abbreviation: Pediatr. Pulmonol. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-08-02 Completed Date: 2010-11-23 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 8510590 Medline TA: Pediatr Pulmonol Country: United States |
Other Details:
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Languages: eng Pagination: 708-16 Citation Subset: IM |
Affiliation:
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Department of Pediatrics and Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Ambulatory Care Facilities Child Child, Preschool Chronic Disease Cross Infection / microbiology Cystic Fibrosis / microbiology* Female Humans Infant Infant, Newborn Longitudinal Studies Male Neonatal Screening* Oropharynx / microbiology Pseudomonas Infections / diagnosis*, transmission* Pseudomonas aeruginosa / genetics*, isolation & purification |
| Grant Support | |
ID/Acronym/Agency:
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5 R01DK34108-17/DK/NIDDK NIH HHS; R01 DK034108-17/DK/NIDDK NIH HHS; R01 DK034108-25/DK/NIDDK NIH HHS |
| Comments/Corrections | |
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