Microbiology profile and severity markers in CF patients / Perfil microbiologico e indicadores de gravidade em pacientes com fibrose cistica

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Objective: To identify the prevalence of organisms in sputum from patients with CF and determine the correlations among the severity markers of disease: Schwachman score, Bhalla score, nutritional status and lung function. Methods: Prospective study (2001-04) performed at the State University of Campinas Medical School.Unicamp. The secretions were obtained from induced cough or sputum samples of 76 patients The cultures took place in a selective media. The genomovars was identified by PCR. The analyzed CF severity variables included score Schwachman in 73 patients , Bhalla score in 64 patientes, weigh and height were assessed by Z score in 65 patients and Pulmonary Function Tests (PFT) in 38 patients. Results: 9.5 years (newborn-22 years) was the mean age anda median of 8.2 years; 39 females. White race: 93.6%. Delta F 508 was present in 83/152 (54.6%) of the analyzed chromosomes. 871 cultures were realized within the mean of cultures/patients/year. Isolated microorganisms: H influenzae = 84.2%; S aureus = 92.1%; MRSA = 1.43, P aeruginosa = 88.2%, (multiresistant 1.49%); P mucóide = 72.4%; B cepacia = 11.8% (multiresistant 17%);S maltophilia = 17.1%; A xylosidans = 9.2%; A fumigatus = 32.9%. Severy markers: score schwachman was obtained in 73/76 patients: (excellent/good: 46.58%, moderate 31.5% and severe 21.92%). Bhalla score was performed in 64/76 CF patients: 15.9±4.66 medium score. The most frequent computer tomography abnormalities were peribronquial wall thickening: 96.9%; mucous plugging: 84.4%; bronchiectasis: 75%; mosaic perfusion: 48.4%. Nutritional Status: Normal in 14%. Malnutrition: 86%. Mild (0 ou = -2) = 51%; moderate: (-2 ou = -3) = 23%; severe (ZP <-3) = 12%,. Short stature (ZA <-3) = 1.5%. PFT was performed in 38 patients older than 7 years. Normal PFT was obtained in 23.68% of the CF patients. Obstructive ventilatory defect: 42.11%; restrictive ventilatory defect 7.9% and obstructive plus restrictive ventilatory defect: 26.32%. A highly significant statistic correlation was observed between SE versus BE (p<0.01); SE versus PFT (p<0.01); BE versus PFT (p<0.01); Nutritional Status versus PFT (p<0.05). BE versus Nutritional Score: Not significant Conclusion: Our study identified a great percentage of Pseudomonas and S aureus colonization in the CF airways. All the analyzed markers showed to be a good value in predicting the severity of the cystic fibrosis patients.

ASSUNTO(S)

fungos tomografia computadorizada nutrição bacterias indicadores espirometria gravidade

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