Geographical differences in first acquisition of Pseudomonas aeruginosa in cystic fibrosis

Ranganathan, Sarath C., Skoric, Billy, Ramsay, Kay A., Carzino, Rosemary, Gibson, Anne-Marie, Hart, Emily, Harrison, Jo, Bell, Scott C. and Kidd, Timothy J. (2013) Geographical differences in first acquisition of Pseudomonas aeruginosa in cystic fibrosis. Annals of the American Thoracic Society, 10 2: 108-114. doi:10.1513/AnnalsATS.201209-077OC

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Author Ranganathan, Sarath C.
Skoric, Billy
Ramsay, Kay A.
Carzino, Rosemary
Gibson, Anne-Marie
Hart, Emily
Harrison, Jo
Bell, Scott C.
Kidd, Timothy J.
Title Geographical differences in first acquisition of Pseudomonas aeruginosa in cystic fibrosis
Formatted title
Geographical differences in first acquisition of Pseudomonas aeruginosa in cystic fibrosis 
Journal name Annals of the American Thoracic Society   Check publisher's open access policy
ISSN 2325-6621
Publication date 2013
Sub-type Article (original research)
DOI 10.1513/AnnalsATS.201209-077OC
Open Access Status DOI
Volume 10
Issue 2
Start page 108
End page 114
Total pages 7
Place of publication New York, NY, United States
Publisher American Thoracic Society
Collection year 2014
Formatted abstract
Rationale: Risk of infection with Pseudomonas aeruginosa in cystic fibrosis (CF) may be associated with environmental factors.

To determine whether residential location is associated with risk of first acquisition of P. aeruginosa.

Methods: Weperformed bronchoalveolar lavage and upper airway cultures in children newly diagnosed with CF to identify infection with P. aeruginosa during infancy and early childhood. Children were assessed according to their residence in a regional or metropolitan area. Multilocus sequence typing was used to determine P. aeruginosa genotype. An environmental questionnaire was also administered.

Measurements and Main Results: A total of 105 of 120 (87.5%) infants diagnosed with CF were included in this study. Diagnosis in 65 infants (61.9%) followed newborn screening at mean age of 4.6 weeks. Sixty subjects (57.1%) were homozygous ΔF508, and 47 (44.8%) were female. Fifty-five (52.3%) infants were regional, of whom 26 (47.3%), compared with 9 of 50 (18.0%) metropolitan children, acquired infection with P. aeruginosa (odds ratio, 4.084; 95% confidence interval, 1.55-11.30). Age at acquisition was similar (regional: median, 2.31 yr; range, 0.27-5.96 yr; metropolitan:median, 3.10 yr, range, 0.89-3.70 yr). Strain typing identified P. aeruginosa genotypes often encountered in different ecological settings and little evidence of cross-infection. Ninety questionnaires (85.7%) were completed. Those who acquired P. aeruginosa were more likely to be living in a household that used water sprinkler systems (P = 0.032), but no differences were identified to explain increased risk of acquisition of P. aeruginosa in regional children.

Conclusions: Geographical difference in residence of children with CF was associated with increased risk of first acquisition of P. aeruginosa, usually with strains associated with the environment rather than with cross-infection. 
Keyword Cystic fibrosis
Early lung disease
Pseudomonas aeruginosa
Pulmonary infection
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Thu, 28 Nov 2013, 17:45:16 EST by System User on behalf of School of Medicine