Inflammatory responses to individual microorganisms in the lungs of children With Cystic Fibrosis

Gangell, Catherine, Gard, Samantha, Douglas, Tonia, Park, Judy, de Klerk, Nicholas, Keil, Tony, Brennan, Siobhain, Ranganathan, Sarath, Robins-Browne, Roy, Sly, Peter D. and on behalf of AREST CF (2011) Inflammatory responses to individual microorganisms in the lungs of children With Cystic Fibrosis. Clinical Infectious Diseases, 53 5: 425-432. doi:10.1093/cid/cir399

Author Gangell, Catherine
Gard, Samantha
Douglas, Tonia
Park, Judy
de Klerk, Nicholas
Keil, Tony
Brennan, Siobhain
Ranganathan, Sarath
Robins-Browne, Roy
Sly, Peter D.
on behalf of AREST CF
Title Inflammatory responses to individual microorganisms in the lungs of children With Cystic Fibrosis
Journal name Clinical Infectious Diseases   Check publisher's open access policy
ISSN 1058-4838
Publication date 2011-09
Sub-type Article (original research)
DOI 10.1093/cid/cir399
Volume 53
Issue 5
Start page 425
End page 432
Total pages 8
Place of publication Cary, NC, United States
Publisher Oxford University Press
Collection year 2012
Language eng
Formatted abstract
We hypothesized that the inflammatory response in the lungs of children with cystic fibrosis (CF) would vary with the type of infecting organism, being greatest with Pseudomonas aeruginosa and Staphylococcus aureus.


A microbiological surveillance program based on annual bronchoalveolar lavage (BAL) collected fluid for culture and assessment of inflammation was conducted. Primary analyses compared inflammation in samples that grew a single organism with uninfected samples in cross-sectional and longitudinal analyses.

Results were available for 653 samples from 215 children with CF aged 24 days to 7 years. A single agent was associated with pulmonary infection (≥105 cfu/mL) in 67 BAL samples, with P. aeruginosa (n = 25), S. aureus (n = 17), and Aspergillus species (n = 19) being the most common. These microorganisms were associated with increased levels of inflammation, with P. aeruginosa being the most proinflammatory. Mixed oral flora (MOF) alone was isolated from 165 BAL samples from 112 patients, with 97 of these samples having a bacterial density ≥105 cfu/mL, and was associated with increased pulmonary inflammation (P < .001). For patients with current, but not past, infections there was an association with a greater inflammatory response, compared with those who were never infected (P < .05). However, previous infection with S. aureus was associated with a greater inflammatory response in subsequent BAL.


Pulmonary infection with P. aeruginosa, S. aureus, or Aspergillus species and growth of MOF was associated with significant inflammatory responses in young children with CF. Our data support the use of specific surveillance and eradication programs for these organisms. The inflammatory response to MOF requires additional investigation.
Keyword Young-Children
Bronchoalveolar Lavage
Pulmonary Inflammation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
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