Pulmonary exacerbations in cystic fibrosis with negative bacterial cultures.
Pulmonary exacerbations in cystic fibrosis with negative bacterial cultures.
复制标题
细菌培养阴性的囊性纤维化肺部恶化。
DOI：
10.1002/ppul.21221
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发表时间：
2010
影响因子：
3.1
通讯作者：
Sagel,ScottD
中科院分区：
文献类型：
--
作者：
Zemanick,EdithT;Wagner,BrandieD;Harris,JKirk;Wagener,JefferyS;Accurso,FrankJ;Sagel,ScottD
研究背景肺疾病加重是囊性纤维化（CF）发病的主要原因，并可能导致肺功能下降。急性加重通常与特征性气道细菌[CF相关细菌（CFRB）]相关。然而，有些患者没有CFRB检测到的文化在acquisitions.ObjectivesWe试图确定的比例气道培养阴性CFRB在肺急性加重，并表征患者谁是CFRB阴性与CFRB阳性。根据入院时的气道培养，将患者分为CFRB阳性或CFRB阴性。人口统计学，临床表现，肺功能，慢性铜绿假单胞菌感染的历史和肺功能的改善与治疗groups.Main ResultsThere有672例入院恶化涉及211例患者超过5年。17%被归类为CFRB阴性。41%的支气管肺泡灌洗（BAL）、32%的咽喉和10%的痰液样本为CFRB阴性。在能够咳痰的患者中，CFRB阴性组更年轻，不太可能患有慢性P。与CFRB阳性培养物的受试者相比，铜绿假单胞菌感染的受试者具有更高的肺功能和体重指数（BMI），并且在入院时具有更低的全身炎症反应。两组有三种或三种以上肺部加重体征和症状的患者数量相似（88% vs. 92%）。两组恢复到基线肺功能后treatment.ConclusionsA显着数量的CF和肺恶化的患者没有典型的CFRB检测文化。无CFRB的患者仍有肺恶化的特征性体征和症状，并对治疗有反应。了解这些患者的病因可能会改善CF肺部加重的诊断和治疗。小儿肺醇。2010; 45：569-577.© 2010 Wiley利斯公司
BackgroundPulmonary exacerbations are a major cause of morbidity in cystic fibrosis (CF) and likely contribute to lung function decline. Exacerbations are often associated with characteristic airway bacteria [CF related bacteria (CFRB)]. However, some patients do not have CFRB detected by culture during exacerbations.ObjectivesWe sought to determine the proportion of airway cultures negative for CFRB during pulmonary exacerbations, and to characterize patients who were CFRB‐negative versus CFRB‐positive.MethodsWe performed a retrospective study of patients with CF admitted for a pulmonary exacerbation. Patients were classified as CFRB‐positive or CFRB‐negative based on admission airway cultures. Demographics, clinical presentation, lung function, history of chronicPseudomonas aeruginosainfection and improvement in lung function with treatment were compared between groups.Main ResultsThere were 672 admissions for exacerbation involving 211 patients over 5 years. Seventeen percent were classified as CFRB‐negative. Forty‐one percent of bronchoalveolar lavage (BAL), 32% of throat and 10% of sputum samples were CFRB‐negative. Among patients capable of expectorating sputum, the CFRB‐negative group was younger, less likely to have chronicP. aeruginosa, had higher lung function and body mass index (BMI), and had a lower systemic inflammatory response on admission compared to those with CFRB‐positive cultures. The two groups had similar numbers of patients with three or more signs and symptoms of a pulmonary exacerbation (88% vs. 92%). Both groups returned to baseline lung function following treatment.ConclusionsA significant number of patients with CF and pulmonary exacerbation did not have typical CFRB detected by culture. Patients without CFRB still had characteristic signs and symptoms of pulmonary exacerbation and responded to treatment. Understanding the causes of illness in these patients may improve the diagnosis and treatment of pulmonary exacerbations in CF. Pediatr Pulmonol. 2010; 45:569–577. © 2010 Wiley‐Liss, Inc.