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European Journal of Pediatrics

, Volume 176, Issue 7, pp 891–897 | Cite as

Palivizumab prophylaxis in infants with cystic fibrosis does not delay first isolation of Pseudomonas aeruginosa or Staphylococcus aureus

  • Clélia Buchs
  • Marie-Laure Dalphin
  • Stéphane Sanchez
  • Marie Perceval
  • Laurianne Coutier
  • Catherine Mainguy
  • Behrouz Kassaï-Koupaï
  • Philippe ReixEmail author
Original Article

Abstract

Respiratory syncytial virus (RSV) infections may worsen cystic fibrosis (CF) lung disease and favor Pseudomonas aeruginosa (Pa) or Staphylococcus aureus (Sa) acquisition, which is of particular importance in the youngest patients. We aimed to determine the effectiveness of PVZ on microbiological outcomes in young children with CF. We conducted a retrospective case–control study to compare these outcomes in children who systematically received PVZ (PVZ+; n = 40) or not (PVZ−; n = 140). One case was matched with at least three same-gender controls born the same year and month. Median (range) age at first Pa isolation was not statistically different between PVZ− (12.3 [3.8–32.6] months) and PVZ+ (10.4 [1.2–33.0] months; p = 0.953) patients. A similar trend was found for Sa (PVZ+: 6.4 [2.0–59.0] months; PVZ−: 3.8 [0.1–74.1] months; p = 0.191). The proportion of Pa isolations by 3 years of age did not differ between groups (PVZ+ 40% vs. PVZ− 41.4%), but this proportion was higher for Sa in the PVZ+ group (97%) than in the PVZ− group (85%; p = 0.001). Healthcare consumption and growth outcomes did not significantly differ between groups.

Conclusion: Systematic PVZ use did not delay key pathogen acquisition in young children with CF.

What is known:

Palivizumab is the only available monoclonal antibody against respiratory syncytial virus infection.

Whether or not it is useful in infants with cystic fibrosis remains controversial.

What is new:

Palivizumab does not delay key pathogens (Pseudomonas aeruginosa, Staphylococcus aureus) first isolation in young children with cystic fibrosis.

Palivizumab does not reduce healthcare consumption or improve growth during the first 3 years of life of young children with cystic fibrosis.

Keywords

Infants Toddlers Cystic fibrosis Palivizumab Pseudomonas aeruginosa Staphylococcus aureus 

Abbreviations

CF

Cystic fibrosis

LRTI

Lower respiratory tract infection

PA

Pseudomonas aeruginosa

PVZ

Palivizumab

RSV

Respiratory syncytial virus

SA

Staphylococcus aureus

Notes

Acknowledgements

We thank the French CF patient organization “Vaincre la Mucoviscidose” for providing data from the national CF registry. We thank Anne Doleans-Jordheim and Florence Morfin-Sherpa for valuable discussions that enhanced this manuscript. We thank Philipp Robinson (DRCI-Hospices Civils de Lyon) for help in preparing the manuscript.

Authors’ contribution

CB: data collection and analysis; first draft manuscript preparation and review

MLD: data analysis, results discussion, manuscript review

SS: statistical analysis

MP: database work-up

LC: data collection, manuscript review

CM: data collection, manuscript review

BKK: study design, results discussion, and manuscript review

PR: study design, data analysis, manuscript writing and reviewing

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Clélia Buchs
    • 1
  • Marie-Laure Dalphin
    • 2
  • Stéphane Sanchez
    • 3
  • Marie Perceval
    • 4
  • Laurianne Coutier
    • 1
  • Catherine Mainguy
    • 1
  • Behrouz Kassaï-Koupaï
    • 5
    • 6
  • Philippe Reix
    • 1
    • 4
    • 6
    • 7
    Email author
  1. 1.Centre de ressources et de compétences de la mucoviscidoseHospices Civils de LyonLyonFrance
  2. 2.Centre de ressources et de compétences de la mucoviscidoseBesançonFrance
  3. 3.Département d’information médicaleCentre Hospitalier de TroyesTroyesFrance
  4. 4.Centre de référence de la mucoviscidoseHospices Civils de LyonLyonFrance
  5. 5.Centre d’investigation clinique pédiatriqueLyonFrance
  6. 6.UMR5558LyonFrance
  7. 7.Centre de ressources et de compétence de la mucoviscidoseHôpital Femme Mère EnfantBRON CedexFrance

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