scholarly journals The clinical significance of oropharyngeal cultures in young children with cystic fibrosis

2018 ◽  
Vol 51 (5) ◽  
pp. 1800238 ◽  
Author(s):  
Oded Breuer ◽  
Daan Caudri ◽  
Lauren Akesson ◽  
Sarath Ranganathan ◽  
Stephen M. Stick ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Lung Disease ◽  
Neutrophil Elastase ◽  
Lung Inflammation ◽  
Interleukin 8 ◽  
Lower Airway ◽  
Increased Risk ◽  
Post Test ◽  
Respiratory Exacerbations

In children with cystic fibrosis (CF) the associations between oropharyngeal swabs (OPSs) for detection of Pseudomonas and lung disease have not been evaluated.OPS and bronchoalveolar lavage (BAL) samples were obtained annually in children with CF from 2005 to 2017. OPS test characteristics were calculated using BAL as “gold standard”. Results were related to lung inflammation (BAL neutrophil elastase and interleukin-8), structural lung disease (chest computed tomography PRAGMA-CF (Perth–Rotterdam Annotated Grid Morphometric Analysis for CF) scores), respiratory exacerbations and future detection of Pseudomonas on BAL.From 181 patients, 690 paired OPS–BAL cultures were obtained. Prevalence of Pseudomonas in BAL was 7.4%. OPS sensitivity was 23.0% and specificity was 91.4%, reducing the post-test probability for a positive BAL following a negative OPS to 6.3%. Pseudomonas on OPS was not associated with lung inflammation or respiratory exacerbations, but was weakly associated with current PRAGMA-CF %Disease score (p=0.043). Pseudomonas on BAL was associated with positive neutrophil elastase (OR 4.17, 95% CI 2.04–8.53; p<0.001), increased interleukin-8 (p<0.001), increased all baseline PRAGMA computed tomography scores (p<0.001), progression of PRAGMA computed tomography scores (p<0.05) and increased risk of respiratory exacerbations (incidence rate ratio 2.11, 95% CI 1.15–3.87; p=0.017).In children with CF OPSs only marginally change the probability of detecting lower airway Pseudomonas and are not associated with lung disease indices nor exacerbations risk.

scholarly journals The lower airway microbiota in early cystic fibrosis lung disease: a longitudinal analysis

Thorax ◽  
2017 ◽  
Vol 72 (12) ◽  
pp. 1104-1112 ◽  
Author(s):  
Katherine B Frayman ◽  
David S Armstrong ◽  
Rosemary Carzino ◽  
Thomas W Ferkol ◽  
Keith Grimwood ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Disease ◽  
Longitudinal Analysis ◽  
Cystic Fibrosis Lung ◽  
Lower Airway ◽  
Cystic Fibrosis Lung Disease

scholarly journals PRAGMA-CF. A Quantitative Structural Lung Disease Computed Tomography Outcome in Young Children with Cystic Fibrosis

2015 ◽  
Vol 191 (10) ◽  
pp. 1158-1165 ◽  
Author(s):  
Tim Rosenow ◽  
Merel C. J. Oudraad ◽  
Conor P. Murray ◽  
Lidija Turkovic ◽  
Wieying Kuo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Young Children ◽  
Lung Disease

Monitoring Cystic Fibrosis Lung Disease by Computed Tomography. Radiation Risk in Perspective

2014 ◽  
Vol 189 (11) ◽  
pp. 1328-1336 ◽  
Author(s):  
Wieying Kuo ◽  
Pierluigi Ciet ◽  
Harm A. W. M. Tiddens ◽  
Wei Zhang ◽  
R. Paul Guillerman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Lung Disease ◽  
Radiation Risk ◽  
Cystic Fibrosis Lung ◽  
Cystic Fibrosis Lung Disease

scholarly journals Inhaled Corticosteroids and the Lung Microbiome in COPD

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1312
Author(s):  
Holly R. Keir ◽  
Marco Contoli ◽  
James D. Chalmers
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Inhaled Corticosteroids ◽  
Bacterial Load ◽  
Chronic Obstructive Lung Disease ◽  
Lower Airway ◽  
Chronic Obstructive ◽  
Pharmacological Management ◽  
Lung Microbiome ◽  
Increased Risk

The Global Initiative for Chronic Obstructive Lung Disease 2021 Report recommends inhaled corticosteroid (ICS)-containing regimens as part of pharmacological treatment in patients with chronic obstructive lung disease (COPD) and frequent exacerbations, particularly with eosinophilic inflammation. However, real-world studies reveal overprescription of ICS in COPD, irrespective of disease presentation and inflammatory endotype, leading to increased risk of side effects, mainly respiratory infections. The optimal use of ICS in COPD therefore remains an area of intensive research, and additional biomarkers of benefit and risk are needed. Although the interplay between inflammation and infection in COPD is widely acknowledged, the role of the microbiome in shaping lower airway inflammation has only recently been explored. Next-generation sequencing has revealed that COPD disease progression and exacerbation frequency are associated with changes in the composition of the lung microbiome, and that the immunosuppressive effects of ICS can contribute to potentially deleterious airway microbiota changes by increasing bacterial load and the abundance of potentially pathogenic taxa such as Streptococcus and Haemophilus. Here, we explore the relationship between microbiome, inflammation, ICS use and disease phenotype. This relationship may inform the benefit:risk assessment of ICS use in patients with COPD and lead to more personalised pharmacological management.

scholarly journals Aspergillus-related lung disease in people with cystic fibrosis: can imaging help us to diagnose disease?

2021 ◽  
Vol 30 (162) ◽  
pp. 210103
Author(s):  
Qianting Lv ◽  
Bernadette B.L.J. Elders ◽  
Adilia Warris ◽  
Daan Caudri ◽  
Pierluigi Ciet ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Lung Disease ◽  
Lung Damage ◽  
Current Evidence ◽  
Resonance Imaging ◽  
Chronic Infections ◽  
Chest Computed Tomography ◽  
Different Types

In people with cystic fibrosis (PwCF), viscous sputum and dysfunction of the mucociliary escalator leads to early and chronic infections. The prevalence of Aspergillus fumigatus in sputum is high in PwCF and the contribution of A. fumigatus to the progression of structural lung disease has been reported. However, overall, relatively little is known about the contribution of A. fumigatus to CF lung disease. More knowledge is needed to aid clinical decisions on whether to start antifungal treatment. In this review, we give an overview of A. fumigatus colonisation and infection in PwCF and the different types of pulmonary disease caused by it. Furthermore, we discuss the current evidence for structural lung damage associated with A. fumigatus in PwCF on chest computed tomography and magnetic resonance imaging. We conclude that radiological outcomes to identify disease caused by A. fumigatus can be important for clinical studies and management.

Sign in / Sign up

Export Citation Format

Share Document