Clinical Outcomes of Achromobacter Species in Adult Cystic Fibrosis Patients: A Cohort Study
Bibliographic record
Abstract
Background. The clinical significance of lung infection in cystic fibrosis (CF) due to classic pathogens is well established. However, Achromobacter species are Gram-negative pathogens increasingly recognized in CF with unclear clinical impact as the evidence is restricted to small European studies. Methods. We conducted a cohort study of CF patients attending a Canadian CF clinic who cultured Achromobacter species in their sputum between 1984 and 2015 to assess the prevalence and clinical impact of infection. Achromobacter was categorized as intermittent (minimum 1 positive culture) or chronic infection (≥2 positive cultures) in the preceding 12 months. Data was collected for a 2-year period prior to and following first Achromobacter isolation. Primary outcome was the proportion of patients with pulmonary exacerbation (PEx) at time of first isolation. Next, those with chronic infection were matched with 2:1 age and sex-matched controls with no history of Achromobacter infection. Multivariable mixed effects models were used to assess rate of PEx and lung function decline. Results. There were 34 patients (11% of clinical cohort) with median age 24.8 (IQR 20.6–30.8) and median BMI of 19.4 kg/m2 (IQR 18.1–22.1) included. Of these, 10 patients (29%) developed chronic infection in the study period, though they did not differ in baseline lung function. 14 patients (41%; 95% CI 25-58%) had a PEx at first isolation and of these, 4 (29%) were severe PEx. Achromobacter isolates displayed multi-drug resistance with resistance rates of 80% to aztreonam, 86% to tobramycin, and 43% to ticarcillin. There was no association of infection with rate of PEx or lung function decline in the total cohort (pre- versus post-index infection) or in the matched cohort. Conclusion. In this Canadian CF cohort, Achromobacter species infection was associated with frequent PEx, including severe PEx, at time of initial isolation but not with increased subsequent PEx risk or lung function decline. Larger multi-center studies are required to further understand the impact of Achromobacter infection in CF. Disclosures. All authors: No reported disclosures
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".