The impact of pseudomonas and staphylococcus in cystic fibrosis

Article Outline

• Copyright

The effects of Pseudomonas aeruginosa and Staphylococcus aureus infection on clinical status and lower airway inflammation in young children with cystic fibrosis were studied in 111 children less than six years of age. The results are published in this issue of The Journal in an article by Sagel et al from the Children's Hospital Denver and the CFF Therapeutics Development Network. Young children with both upper and lower airway Pseudomonas infection had higher neutrophil counts, IL-8, and free neutrophil elastase levels in BAL associated with lower clinical scores, compared with those with only positive upper airway cultures. Staphylococcus aureus was associated with increased lower airway inflammation and the presence of both organisms had an additive affect. These data add to what we already knew—the independent and additive of Staphylococcus infection support the importance of controlling staphylococcal infection.

The results of this study are discussed in an editorial by Richard B. Moss, MD from Stanford University Medical Center. Moss comments on the significance of this paper, which is the largest cohort of young children assessed for infection and inflammation by bronchoscopy. He also comments on the limitations of the study which are related to the entry criteria. Moss goes on to say that this study adds to the growing body of evidence about the importance of polymicrobial infection in cystic fibrosis and the need for future prospective studies in cohorts of infants with cystic fibrosis identified by newborn screening.