Impact of Modulator Therapy on the Chronic Colonization of Lower Respiratory Tract Pathogens in Children: Data From Cystic Fibrosis Registry of Turkey.
Birce Sunman, Ebru Yalçın, Meltem Akgül Erdal, Velat Şen, Azer Kılıç Başkan, Ayşe Ayzıt Kılınç, Hakan Yazan, Erkan Çakır, Ayşegül Doğan Demir, Gökçen Ünal, Suat Savaş, Sevgi Pekcan, Merve Korkmaz, Yakup Canıtez, Gökçen Kartal Öztürk, Figen Gülen, Elif Arık, Özlem Keskin, Ali Ersoy, Mehmet Köse, Mahir Serbes, Derya Ufuk Altıntaş, Abdurrahman Erdem Başaran, Ayşen Bingöl, Zeynep İlkşen Hocoğlu, Ayşe Tana Aslan, Demet Polat Yuluğ, Ali Özdemir, Satı Özkan Tabakçı, Dilber Ademhan Tural, Koray Harmancı, Beste Özsezen, Nazan Çobanoğlu, Sedef Narin Tongal, Gönül Çaltepe, Melih Hangül, Zeynep Gökçe Gayretli Aydın, Mehmet Kılıç, Mina Hızal, Nilay Baş, Gizem Özcan, Tuğba Şişmanlar Eyüboğlu, Nagehan Emiralioğlu, Güzin Cinel, Uğur Özçelik, Deniz Doğru
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引用次数: 0
Abstract
Background: Modulators have revolutionized cystic fibrosis (CF) management, but their effects on respiratory pathogens remain unclear. This study evaluated changes in lower respiratory tract pathogen detection after modulator therapy in children with CF, registered in the Cystic Fibrosis Registry of Turkey.
Method: This retrospective, multicenter cohort study included children receiving modulator therapy between 2020 and 2022. Chronic respiratory tract colonization rates before and after therapy were compared, along with inhaler treatments, oral steroid, azithromycin use, pulmonary function tests, and hospitalizations for pulmonary exacerbations. The cohort was stratified by age, modulator type, and lung disease severity. Changes in microbiologic data over a 1-year period were also analyzed for children not receiving modulator therapy.
Results: A total of 101 children (mean age 9.95 ± 4.44 years) were included. Following modulator therapy, respiratory cultures of 57 (56.4%) were negative. Among 32 children with chronic Pseudomonas aeruginosa (P. aeruginosa) colonization, 14 (44%) showed negative respiratory cultures after receiving modulator therapy (p = 0.039). Conversion to culture-negative status was significant for methicillin-sensitive Staphylococcus aureus (MSSA) (p = 0.022) and methicillin-resistant Staphylococcus aureus (MRSA) (p = 0.034), with ETI therapy yielding the highest conversion rates. Inhaled antibiotic use for chronic respiratory pathogens decreased significantly (p = 0.039), and spirometry parameters improved (p < 0.001). Among 1232 children not receiving modulators, 180 (14.6%) had negative respiratory cultures when examined at 1-year interval. In the same group, intermittent/chronic P. aeruginosa colonization was negative in 58 cases, while 85 developed new growth, following modulator therapy, with positivity rates rising from 16.3% to 18.5% (p = 0.030). No significant changes in other pathogen detection were observed.
Conclusion: Modulators, particularly ETI, reduced respiratory pathogen detection and improved lung function in children with CF.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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