Epidemiology of Chronic Pseudomonas Lung Infections in Cystic Fibrosis Adolescents and Adults
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Rationale: Chronic Pseudomonas aeruginosa lung infection is common and associated with significant morbidity and mortality in cystic fibrosis. Whether recent advances in care have affected the frequency of this chronic infection is unknown. Objectives: Determine if there was a significant change in the incidence of developing chronic Pseudomonas aeruginosa infection among adolescents and adults with cystic fibrosis between 2003 and 2012. Methods: The retrospective cohort consisted of individuals with cystic fibrosis followed in the CF Foundation Patient Registry who were 13 years of age and older without chronic Pseudomonas aeruginosa at baseline. Multivariable regression models accounting for within patient correlation were used to assess the change in incidence of developing chronic Pseudomonas aeruginosa infection between 2003 and 2012. Measurements and Main Results: During the ten-year observation period, 15,504 individuals were followed for a median of 5 (IQR 2-9) years. The incidence of developing chronic Pseudomonas aeruginosa decreased from 14.3% in 2003 to 6.4% in 2012. After adjusting for potential confounding, there was a significant decrease in the relative risk of developing chronic Pseudomonas aeruginosa infection compared to 2003 (P value test of trend < 0.001). Relative to 2003, the risk of developing chronic Pseudomonas aeruginosa infection in 2012 was 0.33 (95% CI: 0.30-0.37). Conclusions: Among individuals with cystic fibrosis, a significant decrease in the incidence of developing chronic Pseudomonas aeruginosa infection between 2003 and 2012 was observed. Whether this change in incidence results in changes in clinical outcomes warrants further exploration.
- Epidemiology