Viral and atypical bacterial infections in the outpatient pediatric cystic fibrosis clinic.

Hanne Vebert Olesen, Lars P Nielsen, Peter Oluf Schiotz

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Abstract

BACKGROUND: Respiratory viral and atypical bacterial infections are associated with pulmonary exacerbations and hospitalisations in cystic fibrosis patients. We wanted to study the impact of such infections on children attending the outpatient clinic. METHODS: Seventy-five children were followed for 12 months at regular clinic visits. Routine sputum/laryngeal aspirations were tested with PCR for 7 respiratory viruses. Antibodies against C. pneumoniae, M. pneumoniae and B. pertussis were measured every 3-4 months. FEV-1, FEF(25-75) and specific airway resistance, "viral" symptoms and bacterial culture were recorded. RESULTS: Ninety-seven viral and 21 atypical bacterial infections were found. FEV-1 was significantly reduced during viral infection (-12.5%, p=0.048), with the exception of rhinovirus infection. A small change in FEV-1 (-3%) was seen during atypical bacterial infection (p=0.039). Viral and atypical bacterial infections caused no change in type and frequency of bacterial culture. Positive predictive value of "viral symptoms" was low (0.64%). Eight patients received "unnecessary" antibiotics because of viral symptoms. CONCLUSIONS: Some viral infections and atypical bacterial infections affect FEV-1 acutely. Viral infections did not precipitate bacterial infection or change of colonisation. Clinical symptoms failed to diagnose viral infection accurately. Routine surveillance for virus or atypical bacteria seems not to be justified in this patient category.
Udgivelsesdato: 2006-Dec
Original languageEnglish
JournalPediatric Pulmonology
Volume41
Pages (from-to)1197-204
Number of pages7
ISSN8755-6863
DOIs
Publication statusPublished - 2006
Externally publishedYes

Keywords

  • Adolescent
  • Ambulatory Care Facilities
  • Antibodies, Bacterial
  • Atypical Bacterial Forms
  • Bacterial Infections
  • Child
  • Child, Preschool
  • Cystic Fibrosis
  • DNA, Viral
  • Enzyme-Linked Immunosorbent Assay
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Polymerase Chain Reaction
  • Prognosis
  • Respiratory Tract Infections
  • Retrospective Studies
  • Virus Diseases
  • Viruses

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