Inflammatory Responses to Individual Microorganisms in the Lungs of Children With Cystic Fibrosis
Inflammatory Responses to Individual Microorganisms in the Lungs of Children With Cystic Fibrosis
复制标题
DOI：
10.1093/cid/cir399
复制
发表时间：
2011-09-01
影响因子：
11.8
通讯作者：
Sly, Peter D.
中科院分区：
文献类型：
--
作者：
Gangell, Catherine;Gard, Samantha;Sly, Peter D.
背景。我们假设囊性纤维化 (CF) 儿童肺部的炎症反应会因感染微生物的类型而异，其中铜绿假单胞菌和金黄色葡萄球菌的炎症反应最大。方法。进行了基于每年支气管肺泡灌洗（BAL）收集液体进行培养和炎症评估的微生物监测计划。初步分析在横断面和纵向分析中比较了生长单一生物体的样本与未感染样本的炎症。结果。结果来自 215 名 24 天至 7 岁的 CF 儿童的 653 个样本。在 67 个 BAL 样本中，单一病原体与肺部感染 (>= 10(5) cfu/mL) 相关，其中铜绿假单胞菌 (n = 25)、金黄色葡萄球菌 (n = 17) 和曲霉属 (n = 19) 是最常见的。这些微生物与炎症水平升高有关，其中铜绿假单胞菌是最促炎症的。从 112 名患者的 165 个 BAL 样本中分离出单独的混合口腔菌群 (MOF)，其中 97 个样本的细菌密度 >= 10(5) cfu/mL，并且与肺部炎症增加相关 (P < .001)。对于当前而非过去感染的患者，与从未感染过的患者相比，炎症反应更大（P < .05）。然而，先前的金黄色葡萄球菌感染与随后的 BAL 中更大的炎症反应相关。结论。铜绿假单胞菌、金黄色葡萄球菌或曲霉属的肺部感染以及 MOF 的生长与 CF 幼儿的显着炎症反应相关。我们的数据支持对这些生物体采取特定的监测和根除计划。 MOF 的炎症反应需要进一步研究。
Background. We hypothesized that the inflammatory response in the lungs of children with cystic fibrosis (CF) would vary with the type of infecting organism, being greatest with Pseudomonas aeruginosa and Staphylococcus aureus.Methods. A microbiological surveillance program based on annual bronchoalveolar lavage (BAL) collected fluid for culture and assessment of inflammation was conducted. Primary analyses compared inflammation in samples that grew a single organism with uninfected samples in cross-sectional and longitudinal analyses.Results. Results were available for 653 samples from 215 children with CF aged 24 days to 7 years. A single agent was associated with pulmonary infection (>= 10(5) cfu/mL) in 67 BAL samples, with P. aeruginosa (n = 25), S. aureus (n = 17), and Aspergillus species (n = 19) being the most common. These microorganisms were associated with increased levels of inflammation, with P. aeruginosa being the most proinflammatory. Mixed oral flora (MOF) alone was isolated from 165 BAL samples from 112 patients, with 97 of these samples having a bacterial density >= 10(5) cfu/mL, and was associated with increased pulmonary inflammation (P < .001). For patients with current, but not past, infections there was an association with a greater inflammatory response, compared with those who were never infected (P < .05). However, previous infection with S. aureus was associated with a greater inflammatory response in subsequent BAL.Conclusions. Pulmonary infection with P. aeruginosa, S. aureus, or Aspergillus species and growth of MOF was associated with significant inflammatory responses in young children with CF. Our data support the use of specific surveillance and eradication programs for these organisms. The inflammatory response to MOF requires additional investigation.