Clinical Course of Children with Chronic Suppurative Lung Disease or Bronchiectasis Infected with <i>Pseudomonas aeruginosa</i>
Elpiniki Kartsiouni,
Stylianos Chatzipanagiotou,
Angeliki Galani,
Dafni Moriki,
Olympia Sardeli,
Spyridon Prountzos,
Efthymia Alexopoulou,
Ioanna Loukou,
Kostas N. Priftis,
Konstantinos Douros
Affiliations
Elpiniki Kartsiouni
Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Stylianos Chatzipanagiotou
Department of Medical Biopathology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
Angeliki Galani
Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Dafni Moriki
Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Olympia Sardeli
Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Spyridon Prountzos
2nd Radiology Department, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Efthymia Alexopoulou
2nd Radiology Department, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
Ioanna Loukou
Cystic Fibrosis Department, Agia Sofia Children’s Hospital, 11527 Athens, Greece
Kostas N. Priftis
Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Konstantinos Douros
Pediatric Allergy and Respiratory Unit, 3rd Department of Pediatrics, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Children with chronic wet cough and without cystic fibrosis (non-CF) may suffer from chronic suppurative lung disease (CSLD) or bronchiectasis. Pseudomonas aeruginosa (Pa) can be one of the offending microbes in these children. The present study aimed to describe the clinical course of children with the above two conditions who were infected with Pa. Data of 54 children with CSLD/bronchiectasis who were diagnosed and attended in our department were retrospectively analysed through a Cox proportional hazard model, with age, presence of bronchiectasis, use of inhaled colistin, azithromycin, inhaled hypertonic saline as the covariates. In 42 of the 54 patients, there was no identifiable cause or underlying chronic disorder. Microbiological clearance was defined as the absence of daily wet cough for four months along with four negative cultures taken during the last four consecutive follow-up visits. Multivariate analysis was performed with a Cox proportional hazard model with time to microbiological clearance as the outcome. Results are described as Hazard Ratios (HR) with 95% Confidence Intervals (95%CI). Nebulised antibiotics and the presence of bronchiectasis were statistically significant predictors of remission (HR: 3.99; 95%CI: 1.12–14.14; p = 0.032, and HR: 0.24; 95%CI: 0.08–0.71; p = 0.010). In conclusion, the rate of microbiological clearance increases with the use of inhaled colistin and decreases when there is established bronchiectasis.
