- 作者：Scott D. Sagel ; Ronald L. Gibson ; Julia Emerson ; Sharon McNamara ; Jane L. Burns ; Jeffrey S. Wagener ; Bonnie W. Ramsey Inhaled Tobramycin in Young Children Study Group ; Cystic Fibrosis Foundation Therapeutics Development Network
- 刊名：The Journal of Pediatrics
- 出版年：2009
- 出版时间：February 2009
- 年：2009
- 卷：154
- 期：2
- 页码：183-188.e3
- 全文大小：295 K
ss=""h4"">Objective
To assess the effects of Pseudomonas aeruginosa and Staphylococcus aureus infection on lower airway inflammation and clinical status in young children with cystic fibrosis (CF).ss=""h4"">Study design
We studied 111 children age < 6 years who had 2 P aeruginosa–positive oropharyngeal cultures within 12 months. We examined bronchoalveolar lavage fluid (BALF) inflammatory markers (ie, cell count, differential, interleukin [IL]-8, IL-6, neutrophil elastase), CF-related bacterial pathogens, exotoxin A serology, and clinical indicators of disease severity.
ss=""h4"">Results
Young children with CF with both upper and lower airway P aeruginosa infection had higher neutrophil counts, higher IL-8 and free neutrophil elastase levels, increased likelihood of positive exotoxin A titers, and lower Shwachman scores compared with those with positive upper airway cultures only. S aureus was associated with increased lower airway inflammation, and the presence of both P aeruginosa and S aureus had an additive effect on concentrations of lower airway inflammatory markers. BALF markers of inflammation were increased with the number of different bacterial pathogens detected.
ss=""h4"">Conclusions
Young children with CF who have upper and lower airway P aeruginosa infection have increased endobronchial inflammation and poorer clinical status compared with those with only upper airway P aeruginosa infection. The independent and additive effects of S aureus on inflammation support the significance of polymicrobial infection in early CF lung disease.