Original ArticlesClinical outcome after early Pseudomonas aeruginosa infection in cystic fibrosis☆,☆☆
Section snippets
Subjects
The state of Victoria, Australia, has had a newborn screening program for CF since 1989. Diagnosis is confirmed by gene mutation analysis and a sweat chloride level ≥60 mmol/L. By excluding those with meconium ileus or a sibling with CF, this program identifies 93.8% of affected infants.10 Eligible infants were identified between January 1990 and December 1992 and prospectively enrolled from February to December 1992, either within the first 6 months of life (newborn cohort) or at 12 or 24
Subjects
Between 1990 and 1992, 56 of 66 (86%) children given a diagnosis of CF during the neonatal period were enrolled. The 10 non-participants were no different from study subjects in sex, genotype, or pancreatic status at diagnosis; and outcome measures were not significantly different for this group (data not shown).
Subject characteristics at the time of recruitment are shown in Table I.Empty Cell Recruited infants (n = 56)* Final study subjects (n = 53)†
Discussion
This prospective cohort study of unselected infants with CF, identified by newborn screening, showed that 45% had acquired P aeruginosa before 7 years of age. Early acquisition was associated with increased mortality, and survivors had lower NIH scores, lower mean FEV1, and higher hospitalization rates.
Compared with older patients with CF, little is known about P aeruginosa in young children. In another study in infants identified by newborn screening more respiratory symptoms and
Acknowledgements
We thank the Department of Anaesthesia, Royal Children’s Hospital, Melbourne, for their assistance with BL.
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Supported by grants from the Murdoch Children’s Research Institute and the JB Were Charitable Fund, Melbourne. G. Nixon received the Grand Lodge of New Zealand Freemasons Child Health Fellowship.
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Reprint requests: Gillian Nixon, Department of Respiratory Medicine, Royal Children’s Hospital, Flemington Rd, Parkville, Victoria 3052, Australia.