Michael Anstead1, Sonya L Heltshe2, Umer Khan3, Joseph T Barbieri4, Markus Langkamp5, Gerd Döring6, Shimoni Dharia7, Ronald L Gibson2, Miriam M Treggiari8, James Lymp3, Margaret Rosenfeld2, Bonnie Ramsey2. 1. Department of Pediatrics, University of Kentucky, Lexington KY 40563-0284, USA. Electronic address: mianst0@uky.edu. 2. Seattle Children's Hospital and University of Washington School of Medicine, Seattle WA 98105-0371, USA. 3. Seattle Children's Research Institute, Seattle WA 98121, USA. 4. Microbiology and Molecular Genetics, Medical College of Wisconsin, Milwaukee WI 53226, USA. 5. Mediagnost®, Aspenhaustr. 25, 72770 Reutlingen, Germany. 6. Universitätsklinikum Tübingen, Institut für Medizinische Mikrobiologie und Hygiene, Wilhelmstr. 31, 72074 Tübingen, Germany. 7. Department of Pediatric Pulmonology, Children's Hospital of Wisconsin, Milwaukee WI, 53226, USA. 8. Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle WA 98104, USA.
Abstract
BACKGROUND: The prognostic value of Pseudomonas aeruginosa serology for antibiotic therapy in cystic fibrosis patients is not well understood. METHODS: Using five antigens from two ELISAs, we assessed whether positive serology in CF patients participating in the multi-center Early Pseudomonas Infection in Children (EPIC) trial would predict treatment failure, time to pulmonary exacerbation and risk for recurrent P. aeruginosa isolation post eradication. RESULTS:Baseline positive P. aeruginosa serology was not significantly associated with failure of initial P. aeruginosa eradication measured at week 10 (adjusted for baseline culture) but seropositivity to the antigens alkaline protease and exotoxin A was significantly associated with increased risk for recurrent P. aeruginosa isolation during the 60 week post eradication follow-up period (p=0.003 and p=0.001 respectively). There was no association between baseline seropositivity and time to pulmonary exacerbation. CONCLUSION: P. aeruginosa serology may complement culture results in clinicians' efforts to successfully monitor recurrence of early P. aeruginosa in CF patients.
RCT Entities:
BACKGROUND: The prognostic value of Pseudomonas aeruginosaserology for antibiotic therapy in cystic fibrosispatients is not well understood. METHODS: Using five antigens from two ELISAs, we assessed whether positive serology in CFpatients participating in the multi-center Early PseudomonasInfection in Children (EPIC) trial would predict treatment failure, time to pulmonary exacerbation and risk for recurrent P. aeruginosa isolation post eradication. RESULTS: Baseline positive P. aeruginosaserology was not significantly associated with failure of initial P. aeruginosa eradication measured at week 10 (adjusted for baseline culture) but seropositivity to the antigens alkaline protease and exotoxin A was significantly associated with increased risk for recurrent P. aeruginosa isolation during the 60 week post eradication follow-up period (p=0.003 and p=0.001 respectively). There was no association between baseline seropositivity and time to pulmonary exacerbation. CONCLUSION:P. aeruginosaserology may complement culture results in clinicians' efforts to successfully monitor recurrence of early P. aeruginosa in CFpatients.
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