Acquisition and eradication of P. aeruginosa in young children with cystic fibrosis

Eur Respir J. 2009 Feb;33(2):305-11. doi: 10.1183/09031936.00043108. Epub 2008 Nov 14.


When do infants and young children with cystic fibrosis acquire infection with Pseudomonas aeruginosa? Can this be eradicated when first detected? Children <6 yrs of age participated in an annual bronchoalveolar lavage (BAL)-based microbiological surveillance programme in Perth, Australia. When P. aeruginosa was detected, an eradication programme using combination treatment with i.v., oral and nebulised antibiotics was undertaken. Repeat BAL was performed 3 months following treatment, to assess eradication success. P. aeruginosa was detected in 33 (28.4%) children; median (range) age at detection was 30.5 (3.3-71.4) months. P. aeruginosa was mucoid at detection in six (18.2%) out of 33 patients and associated with respiratory symptoms in 16 (48.5%) out of 33 children. In total, 26 children underwent eradication therapy, with P. aeruginosa eradicated in 20 (77%) out of 26 following one eradication cycle and in three (total 88%) additional children following a second cycle. Eradication was associated with a significant decrease in neutrophil elastase and interleukin-1beta in BAL fluid 12 months post eradication. Eradication of Pseudomonas aeruginosa infection is achievable in young children with cystic fibrosis for up to 5 yrs using combination i.v., oral and nebulised antibiotic therapy and is associated with reduced pulmonary inflammation 12 months post eradication.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Bronchoalveolar Lavage Fluid
  • Child, Preschool
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / epidemiology
  • Female
  • Humans
  • Infant
  • Inflammation
  • Interleukin-1beta / metabolism
  • Leukocyte Elastase / metabolism
  • Lung / microbiology
  • Lung / pathology
  • Male
  • Pseudomonas Infections / complications*
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / epidemiology
  • Pseudomonas aeruginosa / metabolism
  • Time Factors


  • Interleukin-1beta
  • Leukocyte Elastase