title: Assessment of serology and spirometry and the combination of both to complement microbiological isolation for earlier detection of Pseudomonas aeruginosa infection in children with cystic fibrosis.
abstract: The aim of this study was to assess whether serology and spirometry and the combination of both can complement culture-based detection for earlier recognition of Pseudomonas aeruginosa infection in children with cystic fibrosis.
  
  
  
  A 4 year longitudinal prospective study that included 67 Slovenian children with cystic fibrosis with a mean age of 10.5 years was conducted. Serology, spirometry and a scoring system combining serology and spirometry were assessed and compared. Infection was confirmed with isolation of Pseudomonas aeruginosa from respiratory samples.
  
  
  
  There was a significantly positive correlation between serology and the combination of serology and spirometry and Pseudomonas aeruginosa isolation (P < 0.01 for both) and a significantly negative correlation between spirometry and Pseudomonas aeruginosa isolation (P < 0.05). An increase in serology for 1 ELISA unit increased the possibility of Pseudomonas aeruginosa isolation 1.6 times. A fall in FEV1% predicted for 10% increased the possibility of Pseudomonas aeruginosa isolation 9.8 times. Binary logistic regression analysis was used to determine the odds ratios and 95% confidence intervals for all three approaches. Serology had the highest specificity (0.80) and the combination of serology and spirometry the highest sensitivity (0.90). Both had a high negative predictive value (0.93 and 0.79 respectively).
  
  
  
  Using serology and the combination of serology and lung function measurement can be beneficial for earlier detection of infection with Pseudomonas aeruginosa in children with cystic fibrosis when done simultaneously with standard culture-based detection from respiratory samples.
authors.affiliation: Department of Pediatrics, Unit for Pulmonary Diseases, University Children's Hospital, University Medical Center Ljubljana, Bohoričeva 20, SI, 1000, Ljubljana, Slovenia. ana.kotnikpirs@kclj.si.|Department of Pediatrics, Faculty of Medicine, University of Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia. ana.kotnikpirs@kclj.si.
authors.forename: Ana
authors.identifier: 0000-0002-1413-6844
authors.initials: A
authors.lastname: Kotnik Pirš
authors.affiliation: Department of Pediatrics, Unit for Pulmonary Diseases, University Children's Hospital, University Medical Center Ljubljana, Bohoričeva 20, SI, 1000, Ljubljana, Slovenia.
authors.forename: Uroš
authors.initials: U
authors.lastname: Krivec
authors.affiliation: Laboratory for Humoral Immunology, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia.
authors.forename: Saša
authors.initials: S
authors.lastname: Simčič
authors.affiliation: Laboratory for Diagnostics of Respiratory Infections, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia.
authors.forename: Katja
authors.initials: K
authors.lastname: Seme
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications* / Q000382:microbiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000175:diagnosis*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012372:ROC Curve; D017524:Slovenia; D013147:Spirometry; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial
keywords: Children; Cystic fibrosis; Early Pseudomonas aeruginosa infection detection; Microbiological isolation