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Impact of Elexacaftor/Tezacaftor/Ivacaftor on Microbiology and Antibiotic Utilization in People With Cystic Fibrosis.
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 DOI: 10.1002/ppul.71038
Cindy L Williams, Joanna Billings, Harriet McGowan, Rebecca McDevitt, Charles R Esther, Cameron J McKinzie, William S Wilson, Charissa W Kam
{"title":"Impact of Elexacaftor/Tezacaftor/Ivacaftor on Microbiology and Antibiotic Utilization in People With Cystic Fibrosis.","authors":"Cindy L Williams, Joanna Billings, Harriet McGowan, Rebecca McDevitt, Charles R Esther, Cameron J McKinzie, William S Wilson, Charissa W Kam","doi":"10.1002/ppul.71038","DOIUrl":"https://doi.org/10.1002/ppul.71038","url":null,"abstract":"<p><strong>Background: </strong>Cystic fibrosis (CF) is a multisystem disease characterized by persistent lung infection. Treatment with elexacaftor/tezacaftor/ivacaftor (ETI) improves respiratory-related quality of life and reduces rates of infection and antibiotic treatments. Reduced antibiotic use may alter bacterial drug resistance patterns.</p><p><strong>Methods: </strong>This was a single center, retrospective, observational study analyzing respiratory cultures obtained from people with CF (pwCF) before and after starting ETI therapy. Antibiotic courses and culture data, including susceptibilities, were obtained from the electronic medical record.</p><p><strong>Results: </strong>There were 312 pwCF on ETI included, with an average age at ETI initiation of 20.9 ± 12.0 years and an average length of time on ETI 2.48 ± 0.69 years. Compared to the pre-ETI period, pwCF post-ETI had reductions in the number of antibiotic courses per year (2.5 to 0.7, p < 0.001), antibiotics utilized per course (1.4 to 1.0, p < 0.001), and percentage of courses including intravenous antibiotics (59% to 38%, p < 0.001). The fraction of pwCF with at least one culture positive for Pseudomonas aeruginosa, Burkholderia species, or Stenotrophomonas maltophilia decreased after ETI initiation, though changes were not significant for Staphylococcus aureus. Antibacterial resistance patterns were similar for most antibiotics in pre- and post-ETI periods, with P. aeruginosa exhibiting more resistance to fluoroquinolones post-ETI. Individuals with resistant organisms pre-ETI were less likely to clear the pathogen post-ETI.</p><p><strong>Conclusion: </strong>Treatment with ETI significantly decreased antibiotic utilization and the prevalence of gram-negative organisms. Although fewer antibiotics were used, antibiotic resistance remained unchanged or even increased post-ETI due largely to the greater persistence of resistant organisms.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 3","pages":"e71038"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Complications and long-term impact of early life pneumonia. 早期肺炎的并发症和长期影响。
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-09-30 DOI: 10.1002/ppul.27299
Adaeze C Ayuk
{"title":"Complications and long-term impact of early life pneumonia.","authors":"Adaeze C Ayuk","doi":"10.1002/ppul.27299","DOIUrl":"10.1002/ppul.27299","url":null,"abstract":"<p><p>Pneumonia is an infection affecting the lower airway, where the air sacs are filled with mucus and pus; and typically presents with cough, fever, and fast breathing. Pneumonia is estimated to be the leading cause of mortality in children under five worldwide with 120 million episodes result in 1 million deaths globally. The Low-Income and Middle-Income Countries (LMICs) are more affected. In a study in southeast Nigeria, bronchopneumonia accounted for 41.9%, of the cases admitted in the tertiary hospitals and in another hospital based study among children, pneumonia had the highest respiratory admission rates at 34.0%. Pneumonia can be caused by various organisms: Bacterial (Streptococcus, staphylococcus etc), Viral (RSV) and recently COVID 19 pneumonia. RSV has been noted globally to be a major cause of childhood lower respiratory tract infection, with morbidity/mortality occurring in 99% of (LMICs). Some of the long term sequalae are discussed.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S51-S53"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recurrent wheezing and asthma-Epidemiology and environmental determinants. 反复喘息和哮喘--流行病学和环境决定因素。
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-09-30 DOI: 10.1002/ppul.27301
Adaeze C Ayuk
{"title":"Recurrent wheezing and asthma-Epidemiology and environmental determinants.","authors":"Adaeze C Ayuk","doi":"10.1002/ppul.27301","DOIUrl":"10.1002/ppul.27301","url":null,"abstract":"<p><p>Wheeze is the musical continuous sound produced by oscillations in any critically narrowed airways, and heard mostly on expiration. It is common in preschool age, about half of all children will experience an episode of wheezing by their sixth birthday. Asthma is usually characterized by cough, wheeze, chest tightness and fast breathing. It is a significant global health issue and affects both children and adults. The prevalence is on the increase, especially in LMIC. Studies from different populations have revealed the key role influencing the progression from preschool wheezing to childhood asthma. Recurrent wheezing is four or more episodes in the preceding year and has a spectrum of phenotypes and with heterogeneous features. Phenotypes of wheezing were proposed to facilitate the identification of young children who are at risk of subsequent development of asthma. The epidemiology and environmental determinants of recurrent wheezing and asthma are discussed.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S54-S56"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lung MRI: The future is now. 肺部核磁共振成像：未来就在眼前
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-10-22 DOI: 10.1002/ppul.27335
Jason C Woods
{"title":"Lung MRI: The future is now.","authors":"Jason C Woods","doi":"10.1002/ppul.27335","DOIUrl":"10.1002/ppul.27335","url":null,"abstract":"<p><p>Tomographic imaging via MRI can capture structural abnormalities at high resolution and reveal functional abnormalities if acquired during respiration. In infants and children with chronic lung diseases, MRI can serve as a safe and effective tool to characterize cardiorespiratory disease where PFTs are not feasible. Functional lung imaging via hyperpolarized Xe MRI has been shown to have very high sensitivity to regional airway obstruction, changes in alveolar-airspace size/structure, and gas-exchange due to abnormalities in the interstitium or blood-flow; the technique is routinely used in ages 5 and up. This summary outlines each of the functional measures currently available using Xe MRI.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S73-S74"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update in Asthma Management in Low-Middle Income Countries. 中低收入国家哮喘管理的最新进展。
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-11-27 DOI: 10.1002/ppul.27373
Ian Lachner, Manuel E Soto-Martínez
{"title":"Update in Asthma Management in Low-Middle Income Countries.","authors":"Ian Lachner, Manuel E Soto-Martínez","doi":"10.1002/ppul.27373","DOIUrl":"10.1002/ppul.27373","url":null,"abstract":"<p><p>Asthma represents a significant global health burden, particularly in low and middle income countries (LMICs), where its impact is disproportionately severe. In these regions, asthma management is characterized by poorer control and greater mortality rates compared to wealthier nations. The prevalence of asthma is on the rise and demographic trends indicate that there would be a greater burden on children given that they represent a larger proportion of the population pyramid in LMICs. Challenges in addressing asthma in LMICs are various, amongst them: health care systems in these countries predominantly focus on acute and infectious diseases, leading to inadequate attention to chronic illnesses. Access to essential controller medications (inhaled corticosteroids) is often limited and availability tends to fluctuate. Infraestructural deficiencies and difficult health care access are also identified barriers. Furthermore, many LMICs struggle to meet the World Health Organization's (WHO) guidelines that are set for a minimum standard of care for asthma treatment. Suggested approaches should be aimed at: foment commitment from local health care providers and governmental involvement on policies to meet minimum standards of care (emphasis on continuous access to controller medications) Equally significant is the implementation of policies designed to augment educational strategies (health care professionals and general population), reduce smoking rates and air pollution.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S99-S101"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bronchiectasis and neutrophil dominant inflammation. 支气管扩张和中性粒细胞主导的炎症。
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-12-31 DOI: 10.1002/ppul.27255
Bruce K Rubin
{"title":"Bronchiectasis and neutrophil dominant inflammation.","authors":"Bruce K Rubin","doi":"10.1002/ppul.27255","DOIUrl":"10.1002/ppul.27255","url":null,"abstract":"","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S27-S28"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sickle Lung Disease Long-Term Consequences and Prevention. 镰状肺疾病的长期后果和预防。
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2025-01-07 DOI: 10.1002/ppul.27374
Sandra Kwarteng Owusu
{"title":"Sickle Lung Disease Long-Term Consequences and Prevention.","authors":"Sandra Kwarteng Owusu","doi":"10.1002/ppul.27374","DOIUrl":"10.1002/ppul.27374","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is of global significance due to its severity and occurrence worldwide. Inheritance of the abnormal hemoglobin structure contributes to microvascular events that underlie the development of the multi-systemic complications seen in the disease pathogenesis. Pulmonary complications are common and heterogeneous including pulmonary hypertension, sleep-disordered breathing and lung function abnormalities. Lung function abnormalities commonly reported among children with SCD living in Africa are restrictive impairments. However, in high-income countries, reports suggest that obstructive lung function impairment is more predominant. The exact process that contributes to lung disease in SCD must be continuously explored and large-scale longitudinal studies employing multiple lung function methods are needed urgently. Lung disease-modifying agents need to be explored to help slow down or prevent the occurrence of pulmonary function abnormalities.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S102-S103"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infection and Inflammation in the Cystic fibrosis (CF) airway. 囊性纤维化 (CF) 气道中的感染和炎症。
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-10-28 DOI: 10.1002/ppul.27355
Malena Cohen-Cymberknoh
{"title":"Infection and Inflammation in the Cystic fibrosis (CF) airway.","authors":"Malena Cohen-Cymberknoh","doi":"10.1002/ppul.27355","DOIUrl":"10.1002/ppul.27355","url":null,"abstract":"<p><p>Cystic fibrosis (CF) airway disease is characterized by chronic infection and neutrophil-driven inflammation, leading to progressive airway damage and early mortality. Infection with Pseudomonas aeruginosa significantly impacts morbidity and mortality, requiring early detection and aggressive antibiotic treatment. Controlling inflammation remains difficult due to the limited availability of effective anti-inflammatory treatments. CFTR modulators show potential in reducing inflammation, but further research is needed. Effective management of CF lung disease requires a comprehensive approach addressing both infection and inflammation.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S82-S83"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting exacerbations in severe preschool wheezers. 预测严重学龄前喘息患者的病情恶化。
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-10-25 DOI: 10.1002/ppul.27338
Michael Fayon, Fabien Beaufils
{"title":"Predicting exacerbations in severe preschool wheezers.","authors":"Michael Fayon, Fabien Beaufils","doi":"10.1002/ppul.27338","DOIUrl":"10.1002/ppul.27338","url":null,"abstract":"<p><p>Simple clinical indices, complex composite phenotyping/endotyping and telehome monitoring now allow us to evaluate the risk of preschool wheezing on a population or individual level. We herein discuss the usefulness of clinical markers which involve underlying issues such as in utero smoke exposure, the pathophysiology of viral-immunological-allergic interactions, and changes in airway epithelium, mesenchyme and smooth muscle cells. The most important unmet need in this age group remains disease-modifying interventions.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S77-S79"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tracing the path from preschool wheezing to asthma. 追溯从学龄前喘息到哮喘的过程
IF 2.7 3区 医学
Pediatric Pulmonology Pub Date : 2025-03-01 Epub Date: 2024-10-03 DOI: 10.1002/ppul.27305
Ellen Kong, Darije Custovic, Adnan Custovic
{"title":"Tracing the path from preschool wheezing to asthma.","authors":"Ellen Kong, Darije Custovic, Adnan Custovic","doi":"10.1002/ppul.27305","DOIUrl":"10.1002/ppul.27305","url":null,"abstract":"<p><p>This short review illustrates, using two recent studies, the potential and challenges of using machine learning methods to identify phenotypes of wheezing and asthma from childhood onwards.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"S62-S63"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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