Pseudomonas aeruginosa eradication therapy and risk of acquiring Aspergillus in young children with cystic fibrosis.

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dc.contributor.author Harun, Sabariah Noor en
dc.contributor.author Holford, Nicholas en
dc.contributor.author Grimwood, Keith en
dc.contributor.author Wainwright, Claire E en
dc.contributor.author Hennig, Stefanie en
dc.contributor.author Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) study group en
dc.date.accessioned 2020-02-11T22:08:43Z en
dc.date.issued 2019-08 en
dc.identifier.issn 0040-6376 en
dc.identifier.uri http://hdl.handle.net/2292/49909 en
dc.description.abstract BACKGROUND:While Aspergillus detection rates in adults, adolescents and older children with cystic fibrosis (CF) have increased, the risk of acquiring this fungal pathogen in young children is unknown. AIM:To determine the risk and explanatory factors of acquiring Aspergillus in children with CF by age 5 years. METHODS:Cross-sectional analysis of clinical, bronchoalveolar lavage and treatment data from the Australasian Cystic Fibrosis Bronchoalveolar Lavage study was used to identify predictive factors for detecting Aspergillus at age 5 years. A parametric repeated time-to-event model quantitatively described the risk and factors associated with acquiring Aspergillus and Pseudomonas aeruginosa from birth until age 5 years. RESULTS:Cross-sectional analysis found that the number of P. aeruginosa eradication courses increased the odds of detecting Aspergillus at age 5 years (OR 1.61, 95% CI 1.23 to 2.12). The median (IQR) age for the first P. aeruginosa positive culture was 2.38 (1.32-3.79) years and 3.69 (1.68-4.74) years for the first Aspergillus positive culture. The risk of P. aeruginosa and Aspergillus events changes with time after the first year of study entry. It also decreases for P. aeruginosa after completing P. aeruginosa eradication (HR 0.15, 95% CI 0.00 to 0.79), but increases for Aspergillus events (HR 2.75, 95% CI 1.45 to 5.41). The risk of acquiring both types of events increases after having had a previous event. CONCLUSION:In young children with CF, completing P. aeruginosa eradication therapy and previous Aspergillus events are associated with increased risk of acquiring Aspergillus. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Thorax en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) study group en
dc.subject Humans en
dc.subject Pseudomonas aeruginosa en
dc.subject Pseudomonas Infections en
dc.subject Cystic Fibrosis en
dc.subject Recurrence en
dc.subject Ceftazidime en
dc.subject Clavulanic Acids en
dc.subject Ticarcillin en
dc.subject Ciprofloxacin en
dc.subject Tobramycin en
dc.subject Anti-Bacterial Agents en
dc.subject Prevalence en
dc.subject Risk Factors en
dc.subject Longitudinal Studies en
dc.subject Cross-Sectional Studies en
dc.subject Bronchoalveolar Lavage en
dc.subject Child, Preschool en
dc.subject Infant en
dc.subject Female en
dc.subject Male en
dc.subject Randomized Controlled Trials as Topic en
dc.subject Pulmonary Aspergillosis en
dc.title Pseudomonas aeruginosa eradication therapy and risk of acquiring Aspergillus in young children with cystic fibrosis. en
dc.type Journal Article en
dc.identifier.doi 10.1136/thoraxjnl-2018-211548 en
pubs.issue 8 en
pubs.begin-page 740 en
pubs.volume 74 en
dc.rights.holder Copyright: The author en
pubs.end-page 748 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Journal Article en
pubs.elements-id 776766 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Medical Sciences en
pubs.org-id Pharmacology en
dc.identifier.eissn 1468-3296 en
pubs.record-created-at-source-date 2019-06-17 en


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