Comparing encounter-based and annualized chronic pseudomonas infection definitions in cystic fibrosis

Margaret Rosenfeld; Anna V Faino; Frankline Onchiri; Melis A Aksit; Scott M Blackman; Elizabeth E Blue; Joseph M Collaco; William W Gordon; Rhonda G Pace; Karen S Raraigh; Yi-Hui Zhou; Garry R Cutting; Michael R Knowles; Michael J Bamshad; Ronald L Gibson

doi:10.1016/j.jcf.2021.07.020

Comparing encounter-based and annualized chronic pseudomonas infection definitions in cystic fibrosis

J Cyst Fibros. 2022 Jan;21(1):40-44. doi: 10.1016/j.jcf.2021.07.020. Epub 2021 Aug 13.

Authors

Affiliations

¹ Department of Pediatrics, University of Washington, Seattle, WA 98195, USA. Electronic address: Margaret.rosenfeld@seattlechildrens.org.
² Children's Core for Biostatistics, Epidemiology and Analytics in Research, Seattle Children's Research Institute, Seattle, WA 98101, USA.
³ Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
⁴ Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
⁵ Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
⁶ Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
⁷ Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA.
⁸ Marsico Lung Institute/Cystic Fibrosis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
⁹ Bioinformatics Research Center and Department of Statistics, North Carolina State University, Raleigh, NC 27695, USA; Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA.
¹⁰ Department of Pediatrics, University of Washington, Seattle, WA 98195, USA; Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA; Division of Genetic Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA.
¹¹ Department of Pediatrics, University of Washington, Seattle, WA 98195, USA.

PMID: 34393091
DOI: 10.1016/j.jcf.2021.07.020

Abstract

Chronic Pseudomonas aeruginosa (Pa) infection is associated with increased morbidity and mortality in people with cystic fibrosis (CF). There is no gold standard definition of chronic Pa infection in CF. We compared chronic Pa definitions using encounter-based versus annualized data in the Early Pseudomonas Infection Control (EPIC) Observational study cohort, and subsequently compared annualized chronic Pa definitions across a range of U.S. cohorts spanning decades of CF care. We found that an annualized chronic Pa definition requiring at least 1 Pa+ culture in 3 of 4 consecutive years ("Green 3/4") resulted in chronic Pa metrics similar to established encounter-based modified Leeds criteria definitions, including a similar age at and proportion who fulfilled chronic Pa criteria, and a similar proportion with sustained Pa infection after meeting the chronic Pa definition. The Green 3/4 chronic Pa definition will be valuable for longitudinal analyses in cohorts with limited culture frequency.

Keywords: Pseudomonas aeruginosa; chronic infection; cystic fibrosis; definitions.

Publication types

Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Chronic Disease
Cohort Studies
Cystic Fibrosis / microbiology*
Humans
Infant
Pseudomonas Infections / diagnosis*
Pseudomonas aeruginosa
Registries
Terminology as Topic*
Time Factors