Journal Article

Changing Prevalence of Lower Airway Infections in Young Children with Cystic Fibrosis

Brennan, Siobhain, Schultz, Andre, Sly, Peter D., Breuer, Oded, Robinson, Philip J., Stick, Stephen M., de Klerk, Nicholas, Robertson, Colin, Keil, Anthony D., Harrison, Joanne, Ranganathan, Sarath, Caudri, Daan, Turkovic, Lidija

2019

Overview

Historical studies suggest that airway infection in cystic fibrosis initiates with and , with later emergence of . species are regarded as relatively infrequent, late-occurring infections. To assess the prevalence and change in prevalence of early lower airway infections in a modern cohort of children with cystic fibrosis. All infants diagnosed with cystic fibrosis after newborn screening participating in the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) cohort study between 2000 and 2018 were included. Participants prospectively underwent BAL at 3-6 months, 1 year, and annually up to 6 years of age. Lower airway infection prevalence was described. Changes in prevalence patterns were assessed longitudinally using generalized estimating equations controlling for age and repeated visits. A total of 380 infants underwent 1,759 BALs. The overall prevalence and median age of first acquisition of the most common infections were as follows: , 11%, 2.5 years; , 8%, 2.4 years; species, 11%, 3.2 years; and , 9%, 3.1 years. During the study, a significant decrease in prevalence of (  < 0.001) and (  < 0.001) was observed with a significant change toward more aggressive treatment. Prevalence of infections did not significantly change (  = 0.669). species and are commonly present in the lower airways from infancy. The decrease in prevalence of and since 2000, coinciding with a more aggressive therapeutic approach, has resulted in becoming the most commonly isolated pathogen in young children. Further research is warranted to understand the implication of these findings.

• Publisher: American Thoracic Society
• Subject: Age / Airway management / Antibiotics / Aspergillosis - epidemiology / Aspergillosis - etiology / Australia - epidemiology / Child, Preschool / Childrens health / Clinical medicine / Cohort Studies / Cystic fibrosis / Cystic Fibrosis - complications / Cystic Fibrosis - epidemiology / Cystic Fibrosis - physiopathology / Epidemiology / Female / Hospitals / Humans / Infant / Infant, Newborn / Lung diseases / Male / Medical screening / Medicine / Microorganisms / Patients / Prevalence / Pseudomonas Infections - epidemiology / Pseudomonas Infections - etiology / Respiratory Tract Infections - epidemiology / Respiratory Tract Infections - etiology / Staphylococcus infections