Antibody response to Pseudomonas aeruginosa in cystic fibrosis patients: a marker of therapeutic success?--A 30-year cohort study of survival in Danish CF patients after onset of chronic P. aeruginosa lung infection

Pediatr Pulmonol. 2004 May;37(5):427-32. doi: 10.1002/ppul.10457.


We studied the effects of increasingly intensive treatment regimens on anti-pseudomonal antibody response and survival in five successive cohorts of a total of 157 Danish cystic fibrosis patients after they had acquired chronic P. aeruginosa lung infection. The time periods were 1971-1975 (N = 21), 1976-1980 (N = 64), 1981-1986 (N = 27), 1987-1993 (N = 26), and 1994-2000 (N = 19). During this 30-year period, we introduced elective 2-week courses of chemotherapy every third month in all chronically infected patients, early aggressive treatment with inhalation of colistin and oral ciprofloxacin for 3 months whenever P. aeruginosa was cultured in sputum from noncolonized patients, and inhalation of recombinant human dornase alfa. There was a significant correlation between the calendar year when chronic P. aeruginosa infection was acquired and the subsequent increase in the level of precipitins (P < 0.00001). The median number of precipitins increased by 5 per year in the oldest calendar year cohort, and 1 per year in the youngest. The median age of onset of chronic P. aeruginosa increased from 9.3 years from 1981-1986 to 13.8 years from 1987-2000. Survival after acquisition of chronic P. aeruginosa lung infection improved with time (P = 0.008). Our study shows that CF patients who are treated intensively have lower antibody responses and longer survival after acquisition of chronic P. aeruginosa lung infection.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Antibodies, Bacterial / analysis*
  • Child
  • Ciprofloxacin / therapeutic use
  • Cohort Studies
  • Colistin / therapeutic use
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / microbiology
  • Cystic Fibrosis / mortality*
  • Deoxyribonuclease I / therapeutic use
  • Humans
  • Immunoelectrophoresis, Two-Dimensional
  • Linear Models
  • Pseudomonas Infections / complications*
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / immunology
  • Survival Analysis
  • Time Factors


  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Antibodies, Bacterial
  • Ciprofloxacin
  • DNASE1 protein, human
  • Deoxyribonuclease I
  • Colistin