Background: Pulmonary infectious inflammation is a major cause of decline in lung function in patients with cystic fibrosis (CF) marked by exacerbations, consequently, slowing evolution of lung disease is a primary aim in CF management. The objective of the study was to analyze the microbiological spectrum from epidemiological point of view in our patients. Methods: An observational, cross-sectional transversal study including fifty-seven patients evaluated the prevalence of CF-related microbes in the study group and their pulmonary status. Results: The most frequent microorganism found in our group, regardless age, was Staphyloccocus aureus, closely followed by Pseudomonas aeruginosa. Bacillus tuberculosis was a rare germ, despite the important frequency in our country. The microbes frequency was different with age groups, thus 3.5% of 1-3 years old children had the methicillin sen sitive Staphylococcus aureus (MSSA) strain, while for the 6-12 years group, Pseudomonas aeruginosa was found in an equal percentage of 14% with MSSA. Pseudomonas prevalence was found in 14.0% of adults and the combined infections were diagnosed in about a fifth of our patients. Conclusions: We concluded that the percentage of respiratory infections with redoubtable microbes is relatively moderate. The presence of underweight among CF patients with severe mutations are risk factor for a worse outcome and measures should be instituted.
1 Rowe SM, Miller S, Sorscher E. J Cystic fibrosis. N Engl J Med 2005;352(19):1992- 2001
2. Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, et al. Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report. J Pediatr 2008;153:S4-14
3. Castellani C, Quinzii C, Altieri S, Mastella G, Assael BM. A pilot survey of cystic fibrosis clinical manifestations in CFTR mutation heterozygotes. Genet Test 2001;5:249-254
4. Ciuca IM, Pop LL, Rogobete AF, Onet DF, Horhat FG. Genetic expression in cystic fibrosis related bone disease. An observational, transversal, cross-sectional study. Clin Lab 2016;62(9):1725-1730
5. Kerem E, Viviani L, Zolin A, Macneill S, Hatziagorou E, et al. Factors associated with FEV1 decline in cystic fibrosis: analysis of the data of the ECFS Patient Registry. Eur Respir J 2014;43(1):125-133
6. Ramsay KA, Sandhu H, Geake JB, Ballard E, O’Rourke P, Wainwright CE, et al. The changing prevalence of pulmonary infection in adults with cystic fibrosis: A longitudinal analysis. J Cyst Fibros 2017;16(1):70-77
7. Ciofu O, Mandsberg LF, Wang H, Høiby N. Phenotypes selected during chronic lung infection in cystic fibrosis patients: implications for the treatment of Pseudomonas aeruginosa biofilm infections. FEMS Immunology & Medical Microbiology 2012;65:215-225
8. Goss CH, Muhlebach MS. Review: Staphylococcus aureus and MRSA in cystic fibrosis. J Cyst Fibros 2011;10:298-306
9. Proesmans M, Balinska-Miskiewicz W, Dupont L, et al. Evaluating the “Leeds criteria” for Pseudomonas aeruginosa infection in a cystic fibrosis centre. Eur Respir J 2006;27(5):937-43
10. Lee TWR, Brownlee KG, Convay SP, Denton M, Littlewood JM. Evaluation of a new definition of chronic P. aeruginosa infection in cystic fibrosis. J Cyst Fibros 2003;2:29- 34
11. Tiddens HAWM, Donaldson SH, Rosenfeld M, Paré PD. Cystic fibrosis lung disease starts in the small airways: Can we treat it more effectively? Pediatr Pulmonol 2010;45:107-117
12. Farrell PM, Rosenstein BJ, White TB, et al. Guidelines for Diagnosis of Cystic Fibrosis in Newborns through Older Adults: Cystic Fibrosis Foundation Consensus Report. J Pediatr 2008;153(2):S4-S14.
13. Popa I, Pop L, Popa Z, Cîlt C. Ghid de management în Mucoviscidoză-Fibroza Chistică, Editura Brumar 2006;9-71
14. McKone E, Emerson SS, Edwards KL, et al. Effect of genotype on phenotype and mortality in cystic fibrosis: retrospective cohort study. Lancet 2003;361:1671-1676.
15. Smyth AR, Bell SC, Bojcin S, et al. European Cystic Fibrosis Society standards of care: best practice guidelines. J Cyst Fibros 2014;13(1):S23-S42.
16. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005;26:319-338
17. Colombo C. Liver disease in cystic fibrosis. Curr Opin Pulm Med 2007;13:529-536.
18. Moran A, Brunzell C, Cohen RC, et al. CFRD Guidelines Committee Clinical care guidelines for cystic fibrosis-related diabetes: a position statement of the American Diabetes Association and a clinical practice guideline of the Cystic Fibrosis Foundation, endorsed by the Pediatric Endocrine Society. Diabetes Care 2010;33:2697-270
19. Ciuca IM, Pop L, Ranetti AL, Popescu I, Almajan- Guta B, Malita IM. Ursodeoxicholic acid effects on cystic fibrosis liver disease. Farmacia 2015;63(4):543-547
20. Milla CE. Association of nutritional status and pulmonary function in children with cystic fibrosis. Curr Opin Pulm Med 2004;10:505-509
21. Turck D, Braegger CP, Colombo C, et al. ESPENESPGHAN-ECFS guidelines on nutrition care for infants. Clin Nutr 2016;35(3):557-77
22. Tamas l, Popa I, Pop L, Anghel A, Popa Z, Marian C. Genetic analysis of CFTR mutations in cystic fibrosis patients from Romania. Timisoara Medical Journal 2006;56(1):23-27
23. Debray D, Kelly D, Houwen R, Strandvik B, Colombo C. Best practice guidance for the diagnosis and management of cystic fibrosis- associated liver disease. J Cyst Fibros 2011;10(2):S29-S36
24. Ciuca IM, Pop L, Tamas L, Taban S. Cystic fibrosis liver disease - from diagnosis to risk factors. Rom J Morphol Embryol 2014;55(1):91-5
25. Kozlowska WJ. Lung Function from Infancy to the Preschool Years after Clinical Diagnosis of Cystic Fibrosis. American J of Resp
Crit Care Med 2008;178(1):42-49
26. Moran A, Dunitz J, Nathan B, Saeed A, Holme B, Thomas W. Cystic fibrosis-related diabetes: current trends in prevalence, incidence, and mortality. Diabetes Care 2009;32:1626 -1631
27. Vanderhelst E. Prevalence and impact on FEV1 decline of chronic methicillin-resistant Staphylococcus aureus (MRSA) colonization in patients with Cystic Fibrosis: A single-center, case control study of 165 patients. J Cyst Fibros 2012;11:2-7
28. Da Silva LVRF, Ferreira F de A, Reis FJC, et al. Pseudomonas aeruginosa infection in patients with cystic fibrosis: scientific evidence regarding clinical impact, diagnosis, and treatment. J Bras Pneumol 2013;39(4):495- 512
29. Bedreag OH, Rogobete AF, Luca L, Neamtu C, Dragulescu DM, Nartita R, Papurica M. Incidence of pathogens infections in a Romanian Intensive Care Unit and sensitivity to antibiotics. A prospective single center study. Acta Medica Marisiensis 2016;62(1):21-26
30. Ratjen G, Comes K, Paul HG, Posselt TO, Wagner K. Harms Effect of continuous antistaphylococcal therapy on the rate of P. aeruginosa acquisition in patients with cystic fibrosis. Pediatr Pulmonol 2001;31(1):13-16