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Title: | Regional differences in infection and structural lung disease in infants and young children with cystic fibrosis. | Authors: | King L.;Ranganathan S.;Vidmar S.;Carzino R.;Frayman K.B. | Institution: | (Carzino, Frayman, King, Ranganathan) Respiratory Diseases Group, Murdoch Children's Research Institute, Victoria, Australia (Frayman, Ranganathan) Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Victoria, Australia (Vidmar) Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia (Frayman, Vidmar, Ranganathan) Department of Paediatrics, University of Melbourne, Victoria, Australia (Frayman) Allergy, Immunology and Cystic Fibrosis, Alfred Health, Victoria, Australia (Frayman) Department of Respiratory Medicine, Monash Children's Hospital, Victoria, Australia | Issue Date: | 1-Nov-2020 | Copyright year: | 2020 | Publisher: | Elsevier B.V. | Place of publication: | Netherlands | Publication information: | Journal of Cystic Fibrosis. 19 (6) (pp 917-922), 2020. Date of Publication: November 2020. | Journal: | Journal of Cystic Fibrosis | Abstract: | Background: Both infection and inflammation are critical to the progression of cystic fibrosis (CF) lung disease. Potential anatomical differences in lower airway infection, inflammation and bronchiectasis in young children with CF raise questions regarding the pathogenesis of early structural lung disease. Method(s): A longitudinal multi-centre birth cohort study of infants newly diagnosed with CF was conducted. Paired bronchoalveolar lavage (BAL) samples were obtained from the right middle lobe (RML) and lingula bronchi. Chest computed tomography (CT) was performed biennially and analysed using the modified CF-CT scoring system. Result(s): One hundred and twenty-four children (0.11 - 7.0 years) contributed 527 BAL samples and underwent 388 CT chest scans. Pro-inflammatory microbes were detected in 279 BAL samples (53%), either in both lingula and RML samples (69%), in the lingula alone (24%), or in the RML alone in only 7% of samples. Overall, the prevalence of structural lung disease was greater in the setting of pro-inflammatory microbes. Although infection was less commonly isolated in the right lung, bronchiectasis was more commonly detected in the right lung compared with the left. No anatomical differences in the presence of air trapping were detected. Conclusion(s): Overall, the detection of pro-inflammatory microbes in the lower airways was associated with increased risk of both air trapping and bronchiectasis. However, the apparent discordance between commonest sites of isolation of pro-inflammatory microbes and the anatomical site of early bronchiectasis warrants further exploration.Copyright © 2019 European Cystic Fibrosis Society | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.jcf.2019.10.018 | PubMed URL: | 31706731 [http://www.ncbi.nlm.nih.gov/pubmed/?term=31706731] | ISSN: | 1569-1993 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/28712 | Type: | Article | Subjects: | Haemophilus parainfluenzae human Human metapneumovirus Human parainfluenza virus 1 Human parainfluenza virus 2 Human parainfluenza virus 3 Human respiratory syncytial virus infant inflammation Influenza A virus left lung longitudinal study *lower respiratory tract infection *lung disease *lung fibrosis lung lavage lung lobe major clinical study male Moraxella catarrhalis multicenter study nonhuman preschool child prevalence Proteus mirabilis Pseudomonas aeruginosa Pseudomonas putida right lung scoring system Serratia marcescens Staphylococcus aureus Stenotrophomonas maltophilia Streptococcus pneumoniae thorax radiography interleukin 8/ec [Endogenous Compound] Achromobacter dentrificans Oligella urethalis *structural lung disease Influenza B virus Achromobacter Achromobacter xylosoxidans Acinetobacter baumannii *anatomical concepts article Aspergillus fumigatus Brevundimonas bronchiectasis bronchoalveolar lavage fluid Burkholderia Burkholderia cepacia Burkholderia gladioli child cohort analysis computer assisted tomography *cystic fibrosis female Haemophilus influenzae *bronchiectasis bronchus *computer assisted tomography controlled study human cell lavage fluid lower respiratory tract *lung lavage *microorganism school child *thorax Human parainfluenza virus 3 Human respiratory syncytial virus infant inflammation Influenza A virus Influenza B virus left lung longitudinal study *lower respiratory tract infection *lung disease *lung fibrosis lung lavage lung lobe major clinical study male Moraxella catarrhalis multicenter study nonhuman preschool child prevalence Proteus mirabilis Pseudomonas aeruginosa Pseudomonas putida right lung scoring system Serratia marcescens Staphylococcus aureus Stenotrophomonas maltophilia Streptococcus pneumoniae thorax radiography Achromobacter xylosoxidans Achromobacter child computer assisted tomography *cystic fibrosis female Haemophilus influenzae Haemophilus parainfluenzae human Human metapneumovirus Human parainfluenza virus 1 Human parainfluenza virus 2 bronchiectasis bronchoalveolar lavage fluid Burkholderia Burkholderia cepacia Burkholderia gladioli cohort analysis nonhuman [m] prevalence [m] right lung [m] school child [m] scoring system [m] *thorax [m] article [m] *bronchiectasis [m] bronchus [m] child [m] cohort analysis [m] *computer assisted tomography [m] controlled study [m] *cystic fibrosis [m] female [m] human [m] human cell [m] infant [m] inflammation [m] lavage fluid [m] lower respiratory tract [m] *lung disease [m] *lung lavage [m] major clinical study [m] male [m] *microorganism [m] Acinetobacter baumannii *anatomical concepts Article Aspergillus fumigatus Brevundimonas |
Type of Clinical Study or Trial: | Observational study (cohort, case-control, cross sectional or survey) |
Appears in Collections: | Articles |
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