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Differences in prevalence and treatment of Pseudomonas aeruginosa in cystic fibrosis centres in Denmark, Norway and Sweden

Knudsen, Per Kristian; Olesen, Hanne V.; Hoiby, Niels; Johannesson, Marie; Karpati, Ferenc; Laerum, Birger N.; Meyer, Peter LU ; Pressler, Tacjana and Lindblad, Anders (2009) 19th Annual North America Cystic Fibrosis Conference In Journal of Cystic Fibrosis 8(2). p.135-142
Abstract
Background: Chronic Pseudomonas aeruginosa (PA) infection causes increased morbidity and mortality in cystic fibrosis (CF). This study aimed to answer the following questions: Does the prevalence of chronic infection with PA differ between the CF centres in Scandinavia? Which differences exist concerning segregation and treatment of PA? Methods: 989 patients (86%) from all eight CF-centres in Scandinavia were included. Demographic and clinical data, including PA colonisation status based oil cultures and serology, were recorded at inclusion. The patients were followed prospectively for 1 year, recording number of days with anti-PA antibiotic treatment. Results: In all pancreatic insufficient (PI) patients (n=890) the prevalence of chronic... (More)
Background: Chronic Pseudomonas aeruginosa (PA) infection causes increased morbidity and mortality in cystic fibrosis (CF). This study aimed to answer the following questions: Does the prevalence of chronic infection with PA differ between the CF centres in Scandinavia? Which differences exist concerning segregation and treatment of PA? Methods: 989 patients (86%) from all eight CF-centres in Scandinavia were included. Demographic and clinical data, including PA colonisation status based oil cultures and serology, were recorded at inclusion. The patients were followed prospectively for 1 year, recording number of days with anti-PA antibiotic treatment. Results: In all pancreatic insufficient (PI) patients (n=890) the prevalence of chronic PA infection at each centre ranged from 25.8% to 48.9%, but were not significantly different. In PI patients <19 years the prevalence was 14.5% in Copenhagen compared to 30.9% in the Swedish centres pooled (p=0.001). In intermittently colonised PI patients < 19 years the median number of days per year oil anti-PA antibiotics was almost 6 times higher in Copenhagen (mean 86 (110), median 61 days) compared to the Swedish centres pooled (mean 27 (52), median 11 days)(p=0.037). The pulmonary function was similar. Conclusions: It is possible to maintain a very low prevalence of chronic PA infection in CF patients <19 years. We speculate that this was most likely due to a very intensive treatment of intermittently colonised patients with inhaled anti-PA antibiotics over prolonged periods of time in some g function was similar in centres with less intensive use of inhaled antibiotics, studies comparing different treatment modalities centres. Since lung function was similar in centres with less intensive use of inhaled antibiotics, studies comparing different treatment modalities and other parts of CF care are needed to define the best clinical practice, including how to use antibiotics in the most rational way. (C) 2008 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Chapter in Book/Report/Conference proceeding
publication status
published
subject
keywords
Prevalence, Cystic fibrosis, Pseudomonas aeruginosa, Antibiotic therapy
in
Journal of Cystic Fibrosis
volume
8
issue
2
pages
135 - 142
publisher
Elsevier
conference name
19th Annual North America Cystic Fibrosis Conference
external identifiers
  • wos:000264412800009
  • scopus:60449108922
ISSN
1569-1993
1873-5010
DOI
10.1016/j.jcf.2008.11.001
language
English
LU publication?
yes
id
ec0dd745-14a6-4d78-8ded-1a2467910ee0 (old id 1401832)
date added to LUP
2009-06-03 15:14:02
date last changed
2017-11-19 03:36:28
@inproceedings{ec0dd745-14a6-4d78-8ded-1a2467910ee0,
  abstract     = {Background: Chronic Pseudomonas aeruginosa (PA) infection causes increased morbidity and mortality in cystic fibrosis (CF). This study aimed to answer the following questions: Does the prevalence of chronic infection with PA differ between the CF centres in Scandinavia? Which differences exist concerning segregation and treatment of PA? Methods: 989 patients (86%) from all eight CF-centres in Scandinavia were included. Demographic and clinical data, including PA colonisation status based oil cultures and serology, were recorded at inclusion. The patients were followed prospectively for 1 year, recording number of days with anti-PA antibiotic treatment. Results: In all pancreatic insufficient (PI) patients (n=890) the prevalence of chronic PA infection at each centre ranged from 25.8% to 48.9%, but were not significantly different. In PI patients &lt;19 years the prevalence was 14.5% in Copenhagen compared to 30.9% in the Swedish centres pooled (p=0.001). In intermittently colonised PI patients &lt; 19 years the median number of days per year oil anti-PA antibiotics was almost 6 times higher in Copenhagen (mean 86 (110), median 61 days) compared to the Swedish centres pooled (mean 27 (52), median 11 days)(p=0.037). The pulmonary function was similar. Conclusions: It is possible to maintain a very low prevalence of chronic PA infection in CF patients &lt;19 years. We speculate that this was most likely due to a very intensive treatment of intermittently colonised patients with inhaled anti-PA antibiotics over prolonged periods of time in some g function was similar in centres with less intensive use of inhaled antibiotics, studies comparing different treatment modalities centres. Since lung function was similar in centres with less intensive use of inhaled antibiotics, studies comparing different treatment modalities and other parts of CF care are needed to define the best clinical practice, including how to use antibiotics in the most rational way. (C) 2008 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.},
  author       = {Knudsen, Per Kristian and Olesen, Hanne V. and Hoiby, Niels and Johannesson, Marie and Karpati, Ferenc and Laerum, Birger N. and Meyer, Peter and Pressler, Tacjana and Lindblad, Anders},
  booktitle    = {Journal of Cystic Fibrosis},
  issn         = {1569-1993},
  keyword      = {Prevalence,Cystic fibrosis,Pseudomonas aeruginosa,Antibiotic therapy},
  language     = {eng},
  number       = {2},
  pages        = {135--142},
  publisher    = {Elsevier},
  title        = {Differences in prevalence and treatment of Pseudomonas aeruginosa in cystic fibrosis centres in Denmark, Norway and Sweden},
  url          = {http://dx.doi.org/10.1016/j.jcf.2008.11.001},
  volume       = {8},
  year         = {2009},
}