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Persistency of Pseudomonas aeruginosa in sputum cultures and clinical outcomes in adult patients with cystic fibrosis

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Abstract

Our objective was to describe the natural history of infection with transmissible and unique strains of P. aeruginosa (PA) in adult CF patients and to determine if clearance of PA from sputum was associated with an improvement in clinical status. This was a 3-year prospective cohort study of adult patients with CF. Sputum was collected at baseline and annually. Rate of decline of FEV1, BMI, exacerbation rate, and time to death or transplant were compared between patients who cleared PA versus those in whom PA was persistent. A total of 373 patients were included in the study, 75% were infected with PA at baseline; 24% were infected with transmissible strains and 51% with unique strains. Patients infected with unique strains were more likely to clear PA from their sputum over 3 years compared to those infected with transmissible strains (19% vs 10%, P = 0.05). Declines in FEV1 and rates of pulmonary exacerbations, deaths, or lung transplants were not different between patients who cleared PA compared to those who remained persistently infected. No clinical benefit was identified in patients who cleared PA from sputum compared to those who remained persistently infected.

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Acknowledgements

Author Contributions

Dr. Burkett is the guarantor and contributed to the data analysis, interpretation, and writing of the manuscript.

Ms. Vandemheen contributed to the study design, data collection, and writing of the manuscript.

Ms. Giesbrecht-Lewis contributed to the data collection, and writing of the manuscript.

Dr. Ramotar contributed to the study design, data collection, interpretation, and writing of the manuscript.

Ms. Ferris contributed to the data collection, and writing of the manuscript.

Dr. Chan contributed to the data collection and writing of the manuscript.

Mr. Doucette contributed to the data analysis and writing of the manuscript.

Dr. Fergusson contributed to the data analysis and writing of the manuscript.

Dr. Aaron is the lead investigator, corresponding author, and contributed to the study design, data collection, analysis, interpretation, and writing of the manuscript.

Financial/nonfinancial disclosures

None.

Funding Source

Funded by Canadian Institutes of Health Research, The Canadian Cystic Fibrosis Foundation and The Ontario Thoracic Society.

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Authors and Affiliations

  1. The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada

    A. Burkett, K. L. Vandemheen, T. Giesbrecht-Lewis, K. Ramotar, S. Doucette, D. Fergusson & S. D. Aaron

  2. The Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    W. Ferris & F. Chan

  3. The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, ON, Canada, K1H 8L6

    S. D. Aaron

Authors
  1. A. Burkett
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  2. K. L. Vandemheen
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  3. T. Giesbrecht-Lewis
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  4. K. Ramotar
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  5. W. Ferris
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  6. F. Chan
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  7. S. Doucette
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  8. D. Fergusson
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  9. S. D. Aaron
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Corresponding author

Correspondence to S. D. Aaron.

Additional information

How does this advance the field? This is the first study to examine clearance of P. aeruginosa from sputa of patients with cystic fibrosis and its relationship to patients’ clinical status.

What are the clinical implications? This study suggests that changes in P. aeruginosa sputum culture status may not reliably predict an improvement in clinical status.

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Burkett, A., Vandemheen, K.L., Giesbrecht-Lewis, T. et al. Persistency of Pseudomonas aeruginosa in sputum cultures and clinical outcomes in adult patients with cystic fibrosis. Eur J Clin Microbiol Infect Dis 31, 1603–1610 (2012). https://doi.org/10.1007/s10096-011-1483-8

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  • DOI: https://doi.org/10.1007/s10096-011-1483-8

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