title: Role of respiratory viruses in pulmonary exacerbations in children with cystic fibrosis.
abstract: BACKGROUND
  The role of respiratory viruses in cystic fibrosis (CF) exacerbations is incompletely understood.
  
  
  METHODS
  Cross-sectional study of CF children with a pulmonary exacerbation. Mid-turbinate swabs were tested by a direct immunofluorescent antibody assay and a multiplex PCR panel (ResPlex II v2.0, Qiagen). Resplex II was also applied to sputum or throat swab samples. Pulmonary function tests and quality of life and severity scores were recorded. Sputum cell counts, bacterial density and cytokines were measured.
  
  
  RESULTS
  26/43 (60.5%) subjects tested positive for at least one respiratory virus by any diagnostic method applied to any sample type. Virus-positive patients were younger (p=0.047), more likely to be male (p=0.029), and had higher CF clinical severity (p=0.041) and lower quality of life (physical) scores (p=0.023) but similar IL-8, neutrophil percentage and elastase levels.
  
  
  CONCLUSIONS
  Compared to non-viral exacerbations, viral-related exacerbations were associated with worse severity and quality of life scores but similar pulmonary inflammation.
authors.affiliation: Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada.
authors.forename: Sandra
authors.initials: S
authors.lastname: Asner
authors.forename: Valerie
authors.initials: V
authors.lastname: Waters
authors.forename: Melinda
authors.initials: M
authors.lastname: Solomon
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Yau
authors.forename: Susan E
authors.initials: SE
authors.lastname: Richardson
authors.forename: Hartmut
authors.initials: H
authors.lastname: Grasemann
authors.forename: Farhad
authors.initials: F
authors.lastname: Gharabaghi
authors.forename: Dat
authors.initials: D
authors.lastname: Tran
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D010614:Pharynx / Q000382:microbiology; D015995:Prevalence; D011788:Quality of Life; D012129:Respiratory Function Tests; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D012720:Severity of Illness Index; D012737:Sex Factors; D014777:Virus Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014780:Viruses / Q000145:classification / Q000302:isolation & purification