title: Lessons from a French collaborative case-control study in cystic fibrosis patients during the 2009 A/H1N1 influenza pandemy.
abstract: BACKGROUND
  Viral infections such as influenza are thought to impact respiratory parameters and to promote infection with Pseudomonas aeruginosa in patients with cystic fibrosis (CF). However, the real morbidity of the influenza virus in CF needs to be further investigated because previous studies were only observational.
  
  
  METHODS
  CF patients were included in a case-control study (n = 44 cases and n = 371 controls) during the 2009 pandemic A/H1N1 influenza. Cases were patients with polymerase reaction chain-confirmed influenza A/H1N1 infection. Controls did not report any influenza symptoms during the same period. Sputum colonization and lung function were monitored during 1 year after inclusion.
  
  
  RESULTS
  Cases were significantly younger than controls (mean(SD) 14.9 years(11) versus 20.1 years (13.2) and significantly less frequently colonized with P. aeruginosa (34 % versus 53 %). During influenza infection, 74 % of cases had pulmonary exacerbation, 92 % had antibiotics adapted to their usual sputum colonization and 82 % were treated with oseltamivir. Two cases required lung transplantation after A/H1N1 infection (one had not received oseltamivir and the other one had been treated late). The cases received a mean number of antibiotic treatments significantly higher during the year after the influenza infection (mean(SD) 2.8 (2.4) for cases versus 1.8(2.1) for controls; p = 0.002). An age-matched comparison did not demonstrate any significant modification of bronchopulmonary bacterial colonization during the year after influenza infection nor any significant change in FEV1 at months 1, 3 and 12 after A/H1N1 infection.
  
  
  CONCLUSIONS
  Our results do not demonstrate any change in sputum colonization nor significant lung disease progression after pandemic A/H1N1 influenza.
  
  
  BACKGROUND
  Clinical Trials.gov registration number: NCT01499914.
authors.affiliation: Hôpital Necker Enfants Malades, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Bucher
authors.affiliation: Hôpital Saint Antoine, Paris, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Boelle
authors.affiliation: Hôpital Cochin, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Hubert
authors.affiliation: Hôpital Necker Enfants Malades, Paris, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Lebourgeois
authors.affiliation: CHU de la Timone, Marseille, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Stremler
authors.affiliation: Centre Hospitalier Lyon sud, Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Durieu
authors.affiliation: CHU Purpan, Toulouse, France.
authors.forename: François
authors.initials: F
authors.lastname: Bremont
authors.affiliation: CHU Hôpital Sud, Rennes, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Deneuville
authors.affiliation: Hôpital Robert Debré, Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Delaisi
authors.affiliation: Hôpital Trousseau, Paris, France.
authors.forename: Harriet
authors.initials: H
authors.lastname: Corvol
authors.affiliation: Centre Hospitalier Intercommunal, Créteil, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bassinet
authors.affiliation: Hôpital Foch, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Grenet
authors.affiliation: Centre Hospitalier Intercommunal, Créteil, France.
authors.forename: Natacha
authors.initials: N
authors.lastname: Remus
authors.affiliation: Centre Hospitalier, Mulhouse, France.
authors.forename: Marie Véronique
authors.initials: MV
authors.lastname: Vodoff
authors.affiliation: Centre Hospitalier Georges Pompidou, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Boussaud
authors.affiliation: CHU, Angers, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Troussier
authors.affiliation: Hôpital Necker Enfants Malades, Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Leruez-Ville
authors.affiliation: GHU Necker-Cochin, Paris, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Treluyer
authors.affiliation: Hôpital Cochin, Paris, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Launay
authors.affiliation: Hôpital Necker Enfants Malades, Paris, France. isabelle.sermet@nck.aphp.fr.|Service de PneumoAllergologie Pédiatrique; INSERM U 1151, Hôpital Necker, 149 rue de Sévres, 75015, Paris, France. isabelle.sermet@nck.aphp.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sermet-Gaudelus
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000235:genetics / Q000382:microbiology*; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D009154:Mutation; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D013183:Sputum / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; C505032:CFTR protein, human; D019005:Cystic Fibrosis Transmembrane Conductance Regulator; D053139:Oseltamivir
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