Abstract
Background: Allergic bronchopulmonary aspergillosis (ABPA) is well described in CF. Many CF patients grow Aspergillus fumigatus (AF) on sputum and cough swabs but do not have ABPA. There is evidence that this is clinically important [Chest 2006;130:222, Ped Pulm 2007;42:785]
Hypothesis: Isolation of AF from sputum or cough swab is associated with a worse clinical state in CF children.
Methods: A retrospective cohort study of all children with CF who had sputum samples or cough swabs positive for AF on >1 occasion at least one month apart between 2008 and 2010. Lung function results and nutritional status were recorded.
Results: 35 children (15 male) were identified who fit the criteria, mean age 11.2 years (SD2.1) mean BMI 17.5. Data were collected on 21 controls (7 male) with CF who had not grown AF during the study period and had never had a diagnosis of ABPA, mean age 11.12 years (SD2.21) mean BMI 17.2. Children with AF had a lower mean FEV1(p<0.0001) over the follow-up period (69.8, SD13.8 vs 89.4, SD11.5), despite a greater number of days of intravenous antibiotics (45 days vs. 2.6 days in the 2 year period (p<0.0001))
Conclusions: Recurrent growths of AF are associated with a worse clinical state, manifest by lower lung function, despite the use of significantly more intravenous antibiotics.
- © 2011 ERS