The association between «Pseudomonas aeruginosa» and «Staphylococcus aureus» airway infections and clinical status in adult cystic fibrosis patients
Notice bibliographique
Résumé
BACKGROUND: Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA) are the most common pathogens infecting the lungs of cystic fibrosis (CF) patients. PA infects 60% of adult patients, causing airway inflammation and tissue damage, which leads to declined lung function and increased mortality. SA infects up to 30% of adult CF patients, but its role in lung pathogenesis is still poorly understood. Polymicrobial infections are common in CF, but the effect of their interactions on CF lung disease has yet to be elucidated. Conflicting findings have shown that co-infection with PA and SA results in increased lung inflammation in young children, but co-infected patients also have better lung function and fewer pulmonary exacerbations than those with PA infection only. The objective of our study was to assess the association between PA and SA infections and lung function (FEV1 %) and exacerbation rate in adult CF patients, as well as their clinical score using the Matouk modified N. Huang clinical score and their inflammatory status using the biomarker C-reactive protein (CRP). METHODS: Adult CF patients followed at the Montreal Chest Institute (MCI) CF clinic in January 2012 were included in two retrospective cohort studies: one cross-sectional study and one longitudinal study. Data was extracted from the MCI CF clinic database and from medical records. Cross-sectional data was collected at a steady-state visit during stable clinical condition. Patients were grouped into 1 of 4 infection status groups: PA only, PA+SA co-infection, SA only, and neither PA nor SA. ANOVA and t-tests were used for cross-sectional comparison between groups and subgroups. We modeled cross-sectional correlations between infection status and FEV1 %, exacerbation rate, clinical score, and CRP, and we modeled longitudinal associations between infection status and FEV1 %, exacerbation rate, and clinical score. RESULTS: Our cross-sectional study included 84 patients. After adjusting for age and sex, we found the following associations when compared to PA only: patients with neither PA nor SA infection had a lower exacerbation rate (p<0.01), better total clinical score (p<0.05), and lower CRP (p<0.01); patients with SA only infection had a lower exacerbation rate (p<0.001) and lower CRP levels (p<0.05). No statistically significant differences were found between PA only and PA+SA co-infection in the crude and adjusted models, and no association between infection status and FEV1 % was seen. Our longitudinal study included 88 patients. When adjusted for age and sex, we found the following associations when compared to PA only: infection with neither PA nor SA was associated with better yearly mean FEV1 % (p<0.05), and higher total clinical score (p<0.0001); PA+SA co-infection was associated with lower exacerbation rate (p<0.05), and higher total clinical score (p<0.0001). CONCLUSION: We performed a cross-sectional study and a longitudinal study, both exploring the relationship between PA and SA infection status and clinical outcome in adult CF patients. The results from our cross-sectional study supported the conclusion that infection with PA only was associated with a more severe disease than infection with neither PA nor SA, but our results did not show a significant difference between PA only and PA+SA co-infection. Our longitudinal study revealed that co-infected patients had a milder disease than patients infected with PA only, as shown by exacerbation rate, total clinical score and clinical subscore. Larger cohort studies are required to solidify the association between PA+SA co-infection and CF lung disease.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».