Elsevier

Journal of Cystic Fibrosis

Volume 11, Issue 5, September 2012, Pages 446-453
Journal of Cystic Fibrosis

Original Article
Risk factors for age at initial Pseudomonas acquisition in the cystic fibrosis epic observational cohort

https://doi.org/10.1016/j.jcf.2012.04.003Get rights and content
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Abstract

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.

Keywords

Cystic fibrosis
Pseudomonas
Risk factors
Epidemiology
Exposure
Environment

Cited by (0)

These results were presented in abstract form at the North American Cystic Fibrosis Conference, New Orleans, Louisiana, USA, May, 2009 [1].

1

Participating clinical sites and investigators are listed in the online supplement, Appendix 1.