Association between Mucoid Pseudomonas Infection and Bronchiectasis in Children with Cystic Fibrosis
Association between Mucoid Pseudomonas Infection and Bronchiectasis in Children with Cystic Fibrosis
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DOI：
10.1148/radiol.2522081882
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发表时间：
2009-08-01
期刊：
影响因子：
19.7
通讯作者：
Brody, Alan S.
中科院分区：
文献类型：
--
作者：
Farrell, Philip M.;Collins, Jannette;Brody, Alan S.
目的：探讨囊性纤维化患儿的支气管扩张症的严重程度与临床和微生物学变量的关系，以明确发生不可逆性肺部疾病的危险因素。材料和方法：在获得机构评审委员会批准和父母知情同意后，对1985年至2009年参加威斯康星州新生儿筛查试验的囊性纤维化患者进行符合HIPAA标准的纵向流行病学评估。薄层胸部计算机断层扫描(CT)用于前瞻性横断面设计，研究年龄从6.6岁到17.6岁(平均11.5岁)的患者。薄层CT评分是由多个评分员以标准化的方式在编码图像上客观确定的。用呼吸道分泌物培养方法将铜绿假单胞菌(PA)分为非粘液型和粘液型。结果：82例患者中68例(83%)有不同程度的支气管扩张。在12个潜在危险因素中，只有呼吸道粘液性PA感染与支气管扩张显著相关(P=0.041)。结论：囊性纤维化患儿的支气管扩张的严重程度与呼吸道粘液性PA感染显著相关，预防支气管扩张的措施应包括减少暴露和早期根除PA。(C)RSNA，2009年
Purpose: To correlate the severity of bronchiectasis in children with cystic fibrosis with clinical and microbiologic variables in order to clarify risk factors for the development of irreversible lung disease.Materials and Methods: After institutional review board approval and parental informed consents were obtained, a HIPAA-compliant longitudinal epidemiologic evaluation was performed in patients with cystic fibrosis who were enrolled in the Wisconsin trial of newborn screening from 1985 to 2009. Thin-section chest computed tomography (CT) was used in a prospective cross-sectional design to study patients ranging in age from 6.6 to 17.6 years (mean, 11.5 years). Thin-section CT scores were determined objectively on coded images by multiple raters in a standardized fashion. Microbiologic data were obtained by means of culture of respiratory secretions by using methods for differentiation of Pseudomonas aeruginosa (PA) as either nonmucoid or mucoid.Results: Eighty-three percent of patients (68 of 82) showed bronchiectasis of varying severity. Of 12 potential risk factors, only respiratory infection with mucoid PA correlated significantly with bronchiectasis (P = .041).Conclusion: The severity of bronchiectasis in children with cystic fibrosis is significantly related to respiratory infection with mucoid PA; attempts to prevent bronchiectasis should include reducing exposure to and early eradication of PA. (c) RSNA, 2009