title: Acquisition and eradication of P. aeruginosa in young children with cystic fibrosis.
abstract: When do infants and young children with cystic fibrosis acquire infection with Pseudomonas aeruginosa? Can this be eradicated when first detected? Children <6 yrs of age participated in an annual bronchoalveolar lavage (BAL)-based microbiological surveillance programme in Perth, Australia. When P. aeruginosa was detected, an eradication programme using combination treatment with i.v., oral and nebulised antibiotics was undertaken. Repeat BAL was performed 3 months following treatment, to assess eradication success. P. aeruginosa was detected in 33 (28.4%) children; median (range) age at detection was 30.5 (3.3-71.4) months. P. aeruginosa was mucoid at detection in six (18.2%) out of 33 patients and associated with respiratory symptoms in 16 (48.5%) out of 33 children. In total, 26 children underwent eradication therapy, with P. aeruginosa eradicated in 20 (77%) out of 26 following one eradication cycle and in three (total 88%) additional children following a second cycle. Eradication was associated with a significant decrease in neutrophil elastase and interleukin-1beta in BAL fluid 12 months post eradication. Eradication of Pseudomonas aeruginosa infection is achievable in young children with cystic fibrosis for up to 5 yrs using combination i.v., oral and nebulised antibiotic therapy and is associated with reduced pulmonary inflammation 12 months post eradication.
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia Perth, Western Australia.
authors.forename: T A
authors.initials: TA
authors.lastname: Douglas
authors.forename: S
authors.initials: S
authors.lastname: Brennan
authors.forename: S
authors.initials: S
authors.lastname: Gard
authors.forename: L
authors.initials: L
authors.lastname: Berry
authors.forename: C
authors.initials: C
authors.lastname: Gangell
authors.forename: S M
authors.initials: SM
authors.lastname: Stick
authors.forename: B S
authors.initials: BS
authors.lastname: Clements
authors.forename: P D
authors.initials: PD
authors.lastname: Sly
mesh_terms: D000284:Administration, Oral; D001992:Bronchoalveolar Lavage Fluid; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007249:Inflammation; D053583:Interleukin-1beta / Q000378:metabolism; D019272:Leukocyte Elastase / Q000378:metabolism; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008297:Male; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D011550:Pseudomonas aeruginosa / Q000378:metabolism; D013997:Time Factors
chemical_list: D053583:Interleukin-1beta; D019272:Leukocyte Elastase