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    Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis

    Access Status
    Fulltext not available
    Authors
    Ramsey, K.
    Ranganathan, S.
    Park, J.
    Skoric, B.
    Adams, A.
    Simpson, S.
    Robins-Browne, R.
    Franklin, P.
    De Klerk, N.
    Sly, P.
    Stick, S.
    Hall, Graham
    Date
    2014
    Type
    Journal Article
    
    Metadata
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    Citation
    Ramsey, K. and Ranganathan, S. and Park, J. and Skoric, B. and Adams, A. and Simpson, S. and Robins-Browne, R. et al. 2014. Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis. American Journal of Respiratory and Critical Care Medicine. 190 (10): pp. 1111-1116.
    Source Title
    American Journal of Respiratory and Critical Care Medicine
    DOI
    10.1164/rccm.201407-1277OC
    ISSN
    1073-449X
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/54721
    Collection
    • Curtin Research Publications
    Abstract

    Rationale: Pulmonary inflammation, infection, and structural lung disease occur early in life in children with cystic fibrosis. Objectives: We hypothesized that the presence of these markers of cystic fibrosis lung disease in the first 2 years of life would be associated with reduced lung function in childhood. Methods: Lung function (forced expiratory volume in the first three-quarters of a second [FEV0.75], FVC) was assessed in individuals with cystic fibrosis diagnosed after newborn screening and healthy subjects during infancy (0–2 yr) and again at early school age (4–8 yr). Individuals with cystic fibrosis underwent annual bronchoalveolar lavage fluid examination, and chest computed tomography. We examined which clinical outcomes (pulmonary inflammation, infection, structural lung disease, respiratory hospitalizations, antibiotic prophylaxis) measured in the first 2 years of life were associated with reduced lung function in infants and young children with cystic fibrosis, using a mixed effects model. Measurements and Main Results: Children with cystic fibrosis (n = 56) had 8.3% (95% confidence interval [CI], –15.9 to –6.6; P = 0.04) lower FEV0.75 compared with healthy subjects (n = 18). Detection of proinflammatory bacterial pathogens (Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, Aspergillus species, Streptococcus pneumoniae) in bronchoalveolar lavage fluid was associated with clinically significant reductions in FEV0.75 (ranging between 11.3 and 15.6%). Conclusions: The onset of lung disease in infancy, specifically the occurrence of lower respiratory tract infection, is associated with low lung function in young children with cystic fibrosis. Deficits in lung function measured in infancy persist into childhood, emphasizing the need for targeted therapeutic interventions in infancy to maximize functional outcomes later in life.

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