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Evaluating the "Leeds criteria" for Pseudomonas aeruginosa infection in a cystic fibrosis centre

Depts of ¹ Paediatric Pulmonology, ³ Adult Pulmonology, ⁴ Laboratory Medicine, Immunology, and ⁵ Microbiology, University Hospital Gasthuisberg, Leuven, Belgium, ² Dept of Paediatrics, Allergology and Cardiology, Wroclaw Medical University, Wroclaw, Poland, ⁶ Dept of Microbiology, Rigshospitalet, University of Copenhagen, Denmark.

CORRESPONDENCE: K. de Boeck, University Hospital Gasthuisberg Leuven, Paediatric Pulmonology, Herestraat 49, 3000 Leuven, Belgium. Fax: 32 16343842. E-mail: christiane.deboeck{at}uz.kuleuven.ac.be

Keywords: Anti-pseudomonal antibodies, chronic lung infection, cystic fibrosis, Pseudomonas aeruginosa

Received: August 26, 2005
Accepted December 10, 2005

Four separate categories of chronic Pseudomonas aeruginosa (Pa) infection in children with cystic fibrosis (CF) have been previously defined, based on airway cultures taken over the previous year.

The aim of the present study was to evaluate this definition in the current authors' paediatric and adult CF clinic using clinical, immunological and lung function parameters.

During follow-up, out of 193 patients, 55 (34%) CF patients had never been infected with Pa, 27 (17%) were free of Pa, 29 (18%) were intermittently infected and 51 (31%) were chronically infected. Disease severity markers, such as lung function, were significantly worse in the chronic group, especially in the paediatric population. Differences in adult patients were smaller and no longer significant. Pa antibodies differed strongly between the groups, and were very high (mean±SD 55.4±5.5) and highly statistically significant from all other groups in the chronic group. They were low and different from all other groups in the never group (1.8±0.6). Pa antibodies did not differ between the free of Pa and the intermittent group.

In conclusion, the current authors confirmed an agreement between Pseudomonas aeruginosa status according to the new definition and clinical status, as well as with the level of Pseudomonas aeruginosa antibodies.

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