BACKGROUND: Risk factors for initial Pseudomonas aeruginosa (Pa) acquisition, particularly environmental exposures, are poorly understood. We aimed to identify such risk factors in order to inform prevention strategies and identify high-risk populations. METHODS: The study cohort included all participants in the U.S. EPIC Observational Study who had no prior Pa-positive respiratory cultures (N=889). Cox proportional hazard models were used to test the effects of factors on age at first Pa-positive respiratory culture. RESULTS: Cystic fibrosis (CF) genotype functional class had an important effect on age at initial Pa acquisition (hazard ratio (HR) comparing minimal to residual CFTR function 2.87 (95% CI 1.88, 4.39)). None of the modifiable risk factors evaluated, including cigarette smoke, hot tub use, breastfeeding, or daycare, was associated with age at Pa acquisition. Similarly, newborn screening was not associated with age at Pa acquisition (HR 0.85, 95% CI 0.66, 1.09). Key associations were validated in a CF Foundation National Patient Registry replication cohort. CONCLUSIONS: Given the ubiquitous presence of Pa in the environment, it may be that many imposed lifestyle changes will have less impact on age at initial Pa acquisition than genetic determinants.
BACKGROUND: Risk factors for initial Pseudomonas aeruginosa (Pa) acquisition, particularly environmental exposures, are poorly understood. We aimed to identify such risk factors in order to inform prevention strategies and identify high-risk populations. METHODS: The study cohort included all participants in the U.S. EPIC Observational Study who had no prior Pa-positive respiratory cultures (N=889). Cox proportional hazard models were used to test the effects of factors on age at first Pa-positive respiratory culture. RESULTS:Cystic fibrosis (CF) genotype functional class had an important effect on age at initial Pa acquisition (hazard ratio (HR) comparing minimal to residual CFTR function 2.87 (95% CI 1.88, 4.39)). None of the modifiable risk factors evaluated, including cigarette smoke, hot tub use, breastfeeding, or daycare, was associated with age at Pa acquisition. Similarly, newborn screening was not associated with age at Pa acquisition (HR 0.85, 95% CI 0.66, 1.09). Key associations were validated in a CF Foundation National Patient Registry replication cohort. CONCLUSIONS: Given the ubiquitous presence of Pa in the environment, it may be that many imposed lifestyle changes will have less impact on age at initial Pa acquisition than genetic determinants.
Authors: Michael W Konstan; Wayne J Morgan; Steven M Butler; David J Pasta; Marcia L Craib; Stefanie J Silva; Dennis C Stokes; Mary Ellen B Wohl; Jeffrey S Wagener; Warren E Regelmann; Charles A Johnson Journal: J Pediatr Date: 2007-06-22 Impact factor: 4.406
Authors: Margaret Rosenfeld; Julia Emerson; Sharon McNamara; Kelli Joubran; George Retsch-Bogart; Gavin R Graff; Hector H Gutierrez; Jamshed F Kanga; Thomas Lahiri; Blake Noyes; Bonnie Ramsey; Clement L Ren; Michael Schechter; Wayne Morgan; Ronald L Gibson Journal: Pediatr Pulmonol Date: 2010-09
Authors: Zhanhai Li; Michael R Kosorok; Philip M Farrell; Anita Laxova; Susan E H West; Christopher G Green; Jannette Collins; Michael J Rock; Mark L Splaingard Journal: JAMA Date: 2005-02-02 Impact factor: 56.272
Authors: Milan Bajmoczi; Mihaela Gadjeva; Seth L Alper; Gerald B Pier; David E Golan Journal: Am J Physiol Cell Physiol Date: 2009-04-22 Impact factor: 4.249
Authors: Hara Levy; Leslie A Kalish; Carolyn L Cannon; K Christopher García; Craig Gerard; Don Goldmann; Gerald B Pier; Scott T Weiss; A A Colin Journal: Pediatr Pulmonol Date: 2008-05
Authors: C Goubau; M Wilschanski; V Skalická; P Lebecque; K W Southern; I Sermet; A Munck; N Derichs; P G Middleton; L Hjelte; R Padoan; M Vasar; K De Boeck Journal: Thorax Date: 2009-03-23 Impact factor: 9.139
Authors: Miriam M Treggiari; Margaret Rosenfeld; Nicole Mayer-Hamblett; George Retsch-Bogart; Ronald L Gibson; Judy Williams; Julia Emerson; Richard A Kronmal; Bonnie W Ramsey Journal: Contemp Clin Trials Date: 2009-01-15 Impact factor: 2.226
Authors: Drucy Borowitz; Karen A Robinson; Margaret Rosenfeld; Stephanie D Davis; Kathryn A Sabadosa; Stephanie L Spear; Suzanne H Michel; Richard B Parad; Terry B White; Philip M Farrell; Bruce C Marshall; Frank J Accurso Journal: J Pediatr Date: 2009-12 Impact factor: 4.406
Authors: P Kubesch; T Dörk; U Wulbrand; N Kälin; T Neumann; B Wulf; H Geerlings; H Weissbrodt; H von der Hardt; B Tümmler Journal: Lancet Date: 1993-01-23 Impact factor: 79.321
Authors: Don B Sanders; Julia Emerson; Clement L Ren; Michael S Schechter; Ronald L Gibson; Wayne Morgan; Margaret Rosenfeld Journal: Ann Am Thorac Soc Date: 2015-08
Authors: S L Heltshe; U Khan; V Beckett; A Baines; J Emerson; D B Sanders; R L Gibson; W Morgan; M Rosenfeld Journal: J Cyst Fibros Date: 2017-10-28 Impact factor: 5.482
Authors: Jesse R Willis; Ester Saus; Susana Iraola-Guzmán; Elena Cabello-Yeves; Ewa Ksiezopolska; Luca Cozzuto; Luis A Bejarano; Nuria Andreu-Somavilla; Miriam Alloza-Trabado; Andrea Blanco; Anna Puig-Sola; Elisabetta Broglio; Carlo Carolis; Julia Ponomarenko; Jochen Hecht; Toni Gabaldón Journal: J Oral Microbiol Date: 2021-05-17 Impact factor: 5.474
Authors: Peter H Gilligan; Damian G Downey; J Stuart Elborn; Patrick A Flume; Sebastian Funk; Deirdre Gilpin; Timothy J Kidd; John McCaughan; B Cherie Millar; Philip G Murphy; Jacqueline C Rendall; Michael M Tunney; John E Moore Journal: J Clin Microbiol Date: 2018-08-27 Impact factor: 5.948