Predictors of pulmonary exacerbations in patients with cystic fibrosis infected with multi-resistant bacteria

Block, J. K., Vandemheen, K. L., Tullis, E., Fergusson, D., Doucette, S., Haase, D., Berthiaume, Y., Brown, N., Wilcox, P., Bye, P., Bell, S., Noseworthy, M., Pedder, L., Freitag, A. and Paterson, N. (2006) Predictors of pulmonary exacerbations in patients with cystic fibrosis infected with multi-resistant bacteria. Thorax, 61 11: 969-974. doi:10.1136/thx.2006.061366

Author Block, J. K.
Vandemheen, K. L.
Tullis, E.
Fergusson, D.
Doucette, S.
Haase, D.
Berthiaume, Y.
Brown, N.
Wilcox, P.
Bye, P.
Bell, S.
Noseworthy, M.
Pedder, L.
Freitag, A.
Paterson, N.
Title Predictors of pulmonary exacerbations in patients with cystic fibrosis infected with multi-resistant bacteria
Journal name Thorax   Check publisher's open access policy
ISSN 0040-6376
Publication date 2006-01-01
Sub-type Article (original research)
DOI 10.1136/thx.2006.061366
Open Access Status Not Open Access
Volume 61
Issue 11
Start page 969
End page 974
Total pages 6
Editor D. Mitchell
S. Johnston
J.A. Wedzicha
Place of publication London, United Kingdom
Publisher BMJ Publishing Group
Language eng
Subject 321027 Respiratory Diseases
730110 Respiratory system and diseases (incl. asthma)
Formatted abstract
This study examined characteristics of adult and adolescent patients with cystic fibrosis ( CF) to determine factors associated with an increased risk of pulmonary exacerbations.

249 patients with CF infected with multidrug resistant bacteria were recruited and prospectively followed for up to 4.5 years until they experienced a pulmonary exacerbation severe enough to require intravenous antibiotics. Multivariable regression analyses were used to compare the characteristics of patients who experienced an exacerbation with those who did not.

124 of the 249 patients ( 50%) developed a pulmonary exacerbation during the first year and 154 ( 62%) experienced an exacerbation during the 4.5 year study period. Factors predictive of exacerbations in a multivariable survival model were younger age ( OR 0.98, 95% CI 0.96 to 0.99), female sex ( OR 1.45, 95% CI 1.07 to 1.95), lower forced expiratory volume in 1 second ( FEV1) ( OR 0.98, 95% CI 0.97 to 0.99), and a previous history of multiple pulmonary exacerbations ( OR 3.16, 95% CI 1.93 to 5.17). Chronic use of inhaled corticosteroids was associated with an increased risk of exacerbation ( OR 1.92, 95% CI 1.00 to 3.71) during the first study year.


Patients who experience pulmonary exacerbations are more likely to be younger, female, using inhaled steroids, have a lower FEV1, and a history of multiple previous exacerbations. It is hoped that knowledge of these risk factors will allow better identification and closer monitoring of patients who are at high risk of exacerbations.
Keyword Randomized Controlled-trial
Recombinant Human Dnase
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 42 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 48 times in Scopus Article | Citations
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Created: Wed, 15 Aug 2007, 19:53:10 EST