title: Pseudomonas aeruginosa genotypes acquired by children with cystic fibrosis by age 5-years.
abstract: BACKGROUND
  We describe Pseudomonas aeruginosa acquisitions in children with cystic fibrosis (CF) aged ≤5-years, eradication treatment efficacy, and genotypic relationships between upper and lower airway isolates and strains from non-CF sources.
  
  
  METHODS
  Of 168 CF children aged ≤5-years in a bronchoalveolar lavage (BAL)-directed therapy trial, 155 had detailed microbiological results. Overall, 201/271 (74%) P. aeruginosa isolates from BAL and oropharyngeal cultures were available for genotyping, including those collected before and after eradication therapy.
  
  
  RESULTS
  Eighty-two (53%) subjects acquired P. aeruginosa, of which most were unique strains. Initial eradication success rate was 90%, but 36 (44%) reacquired P. aeruginosa, with genotypic substitutions more common in BAL (12/14) than oropharyngeal (3/11) cultures. Moreover, oropharyngeal cultures did not predict BAL genotypes reliably.
  
  
  CONCLUSIONS
  CF children acquire environmental P. aeruginosa strains frequently. However, discordance between BAL and oropharyngeal strains raises questions over upper airway reservoirs and how to best determine eradication in non-expectorating children.
authors.affiliation: Queensland Children's Medical Research Institute, Royal Children's Hospital, The University of Queensland, Herston, QLD 4029, Australia. Electronic address: t.m.kidd@uq.edu.au.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Kidd
authors.affiliation: Queensland Children's Medical Research Institute, Royal Children's Hospital, The University of Queensland, Herston, QLD 4029, Australia.
authors.forename: Kay A
authors.initials: KA
authors.lastname: Ramsay
authors.affiliation: Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute and Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia.
authors.forename: Suzanna
authors.initials: S
authors.lastname: Vidmar
authors.affiliation: Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute and Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia.
authors.forename: John B
authors.initials: JB
authors.lastname: Carlin
authors.affiliation: Queensland Children's Medical Research Institute, Royal Children's Hospital, The University of Queensland, Herston, QLD 4029, Australia; Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, QLD 4032, Australia.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Bell
authors.affiliation: Queensland Children's Medical Research Institute, Royal Children's Hospital, The University of Queensland, Herston, QLD 4029, Australia; Queensland Children's Respiratory Centre, Royal Children's Hospital, Herston, QLD 4029, Australia.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Wainwright
authors.affiliation: Queensland Children's Medical Research Institute, Royal Children's Hospital, The University of Queensland, Herston, QLD 4029, Australia; Griffith Health Institute, Griffith University and Gold Coast University Hospital, Southport, QLD 4222, Australia.
authors.forename: Keith
authors.initials: K
authors.lastname: Grimwood
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D009960:Oropharynx / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000235:genetics* / Q000302:isolation & purification; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial
keywords: Cystic fibrosis; Eradication; Genotyping; Infection; Pseudomonas aeruginosa