Clinical outcome after acquisition ofBurkholderia cepacia in patients with cystic fibrosis
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Respiratory disease is the major cause of morbidity and mortality in cystic fibrosis (CF). The significance ofBurkholderia cepacia (B. cepacia) in the pathogenesis of lung disease in CF is debated, but its exact role remains unclear.
To assess the impact of respiratory tract colonisation withB. cepacia in patients with CF by measuring changes in pulmonary function and body mass index (BMI).
Three groups of patients were defined based on sputum culture isolates: Group 1 wereB. cepacia andPseudomonas aeruginosa (P. aeruginosa) positive patients; Group 2 wereP. aeruginosa positive; and Group 3 were colonised with neither organism. Forced expiratory volume (FEV1) and BMI were measured annually from 1987 to 1995 and the year of acquisition ofP. aeruginosa orB. cepacia was recorded.
The mean annual decrease in FEV1 was significantly different in all three groups: Group 1, −5.4 (5.1)%; Group 2, −3.9 (6.5)%; and Group 3, −1.6 (1.0)%, (p<0.05). The mean percentage decrease in FEV1 of a sub-group of Group 1 patients where theB. cepacia acquisition date was known was 6.1% per year versus 1.55% in Group 2 patients (p<0.05).
Acquisition ofB. cepacia may be a cause of, rather than a marker for, a decrease in pulmonary function.
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