Impact of Isolation on the Respiratory Function of Adult Patients with Cystic Fibrosis

Overview

Journal ERJ Open Res

Specialty Pulmonary Medicine

Date 2019 Dec 14

PMID 31832429

Citations 22

Authors

Macha Tetart

Frederic Wallet

Maeva Kyheng

Sylvie Leroy

Thierry Perez

Olivier Le Rouzic

Benoit Wallaert

Anne Prevotat

Affiliations

Soon will be listed here.

Abstract

Background: The prevalence of lung isolation in cystic fibrosis (CF) patients has increased, but the impact on lung function is controversial. The aim of this study was to evaluate the long-term effects of isolation on respiratory function of adult patients with CF in the first 3 years after identification of isolation.

Methods: This was a case-control retrospective study performed at a single CF centre in Lille, France. Data for 36 patients with CF who had at least one sputum culture positive for () were evaluated and compared with control CF patients uninfected by (). Respiratory function and exacerbation frequency were evaluated between 1 year prior to and 3 years after isolation.

Results: Compared with the - group, the group had a lower forced expiratory volume in 1 s (FEV) at baseline (median (interquartile range): 55.2% (50.6-59.8%) 73.8% (67.2-80.4%); p=0.005), a greater decline in FEV (±se) in the first year after identification (-153.6±16.1 mL·year -63.8±18.5 mL·year; p=0.0003), and more exacerbations in the first 3 years after identification (9 (7-12) 7 (5-10); p=0.03). patients co-colonised with (n=27, 75%) had a greater FEV decline (p=0.003) and more exacerbations in the year after identification (p=0.037) compared with patients colonised with alone. Patients with chronic isolation (n=23, 64%) had more exacerbations than intermittently colonised patients in the 3 years after identification (p=0.012).

Conclusion: isolation is associated with a decline in respiratory function in patients with CF. Chronic isolation and co-isolation may be markers of more severe respiratory disease in + patients.

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References

Riordan J, Rommens J, Kerem B, Alon N, Rozmahel R, Grzelczak Z . Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA. Science. 1989; 245(4922):1066-73. DOI: 10.1126/science.2475911. View

Sanders D, Bittner R, Rosenfeld M, Hoffman L, Redding G, Goss C . Failure to recover to baseline pulmonary function after cystic fibrosis pulmonary exacerbation. Am J Respir Crit Care Med. 2010; 182(5):627-32. PMC: 5450763. DOI: 10.1164/rccm.200909-1421OC. View

Yabuuchi E, Oyama A . Achromobacter xylosoxidans n. sp. from human ear discharge. Jpn J Microbiol. 1971; 15(5):477-81. DOI: 10.1111/j.1348-0421.1971.tb00607.x. View

Firmida M, Pereira R, Silva E, Marques E, Lopes A . Clinical impact of Achromobacter xylosoxidans colonization/infection in patients with cystic fibrosis. Braz J Med Biol Res. 2016; 49(4):e5097. PMC: 4792508. DOI: 10.1590/1414-431X20155097. View

Tan K, Conway S, Brownlee K, Etherington C, Peckham D . Alcaligenes infection in cystic fibrosis. Pediatr Pulmonol. 2002; 34(2):101-4. DOI: 10.1002/ppul.10143. View

Somayaji R, Stanojevic S, Tullis D, Stephenson A, Ratjen F, Waters V . Clinical Outcomes Associated with Achromobacter Species Infection in Patients with Cystic Fibrosis. Ann Am Thorac Soc. 2017; 14(9):1412-1418. DOI: 10.1513/AnnalsATS.201701-071OC. View

Szczesniak R, Heltshe S, Stanojevic S, Mayer-Hamblett N . Use of FEV in cystic fibrosis epidemiologic studies and clinical trials: A statistical perspective for the clinical researcher. J Cyst Fibros. 2017; 16(3):318-326. PMC: 5420487. DOI: 10.1016/j.jcf.2017.01.002. View

Kerem E, Reisman J, Corey M, Canny G, Levison H . Prediction of mortality in patients with cystic fibrosis. N Engl J Med. 1992; 326(18):1187-91. DOI: 10.1056/NEJM199204303261804. View

Abbott I, Peleg A . Stenotrophomonas, Achromobacter, and nonmelioid Burkholderia species: antimicrobial resistance and therapeutic strategies. Semin Respir Crit Care Med. 2015; 36(1):99-110. DOI: 10.1055/s-0034-1396929. View

10.

Kidd T, Ramsay K, Hu H, Bye P, Elkins M, Grimwood K . Low rates of Pseudomonas aeruginosa misidentification in isolates from cystic fibrosis patients. J Clin Microbiol. 2009; 47(5):1503-9. PMC: 2681828. DOI: 10.1128/JCM.00014-09. View

11.

Ratjen F, Doring G . Cystic fibrosis. Lancet. 2003; 361(9358):681-9. DOI: 10.1016/S0140-6736(03)12567-6. View

12.

Hansen C, Pressler T, Nielsen K, Jensen P, Bjarnsholt T, Hoiby N . Inflammation in Achromobacter xylosoxidans infected cystic fibrosis patients. J Cyst Fibros. 2009; 9(1):51-8. DOI: 10.1016/j.jcf.2009.10.005. View

13.

Edwards B, Greysson-Wong J, Somayaji R, Waddell B, Whelan F, Storey D . Prevalence and Outcomes of Achromobacter Species Infections in Adults with Cystic Fibrosis: a North American Cohort Study. J Clin Microbiol. 2017; 55(7):2074-2085. PMC: 5483909. DOI: 10.1128/JCM.02556-16. View

14.

Lambiase A, Catania M, Del Pezzo M, Rossano F, Terlizzi V, Sepe A . Achromobacter xylosoxidans respiratory tract infection in cystic fibrosis patients. Eur J Clin Microbiol Infect Dis. 2011; 30(8):973-80. PMC: 3132409. DOI: 10.1007/s10096-011-1182-5. View

15.

Hansen C, Pressler T, Hoiby N, Gormsen M . Chronic infection with Achromobacter xylosoxidans in cystic fibrosis patients; a retrospective case control study. J Cyst Fibros. 2006; 5(4):245-51. DOI: 10.1016/j.jcf.2006.04.002. View

16.

De Baets F, Schelstraete P, Van Daele S, Haerynck F, Vaneechoutte M . Achromobacter xylosoxidans in cystic fibrosis: prevalence and clinical relevance. J Cyst Fibros. 2006; 6(1):75-8. DOI: 10.1016/j.jcf.2006.05.011. View

17.

Smyth A, Bell S, Bojcin S, Bryon M, Duff A, Flume P . European Cystic Fibrosis Society Standards of Care: Best Practice guidelines. J Cyst Fibros. 2014; 13 Suppl 1:S23-42. DOI: 10.1016/j.jcf.2014.03.010. View

18.

Que C, Cullinan P, Geddes D . Improving rate of decline of FEV1 in young adults with cystic fibrosis. Thorax. 2005; 61(2):155-7. PMC: 2104571. DOI: 10.1136/thx.2005.043372. View

19.

. Standardized lung function testing. Official statement of the European Respiratory Society. Eur Respir J Suppl. 1993; 16:1-100. View

20.

Kerem E, Viviani L, Zolin A, Macneill S, Hatziagorou E, Ellemunter H . Factors associated with FEV1 decline in cystic fibrosis: analysis of the ECFS patient registry. Eur Respir J. 2013; 43(1):125-33. DOI: 10.1183/09031936.00166412. View