Acquisition and Eradication of P. aeruginosa in Young Children with Cystic Fibrosis

¹ Dept of Respiratory Medicine, Princess Margaret Hospital Perth, Western Australia 6008; and Division of Clinical Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia Perth, Western Australia
² Division of Clinical Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia Perth, Western Australia
³ Dept of Respiratory Medicine, Princess Margaret Hospital Perth, Western Australia 6008

^* To whom correspondence should be addressed. E-mail: peters{at}ichr.uwa.edu.au.

	Abstract

When do infants and young children with cystic fibrosis (CF) acquire infection with Pseudomonas aeruginosa (Psa)? Can this be eradicated when first detected?

Children less than 6 years of age participate in an annual bronchoalveolar lavage (BAL)-based microbiological surveillance program in Perth, Australia. When Psa was detected an eradication program using combination treatment with intravenous, oral and nebulised antibiotics was undertaken. Repeat BAL was performed 3 months following treatment to assess eradication success.

Psa was detected in 33 (28.4%) children; median age at detection was 30.5 months [range 3.3–71.4]. Psa was mucoid at detection in 6/33 (18.2%) and associated with respiratory symptoms in 16/33 (48.5%). 26 children underwent eradication therapy with Psa eradicated in 20/26 (77%) following one eradication cycle and in 3 additional children (total 88%) following a second cycle. Eradication was associated with a significant decrease in neutrophil elastase (p=0.003) and IL1 (p=0.003) in BAL fluid 12 months post eradication.

Eradication of Psa infection is achievable in young children with CF for up to 5 years using combination intravenous, oral and nebulised antibiotic therapy and is associated with reduced pulmonary inflammation 12 months post eradication.

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