Barsky EE, et al. – In this longitudinal study, the physicians wished to analyze whether incident detection of Stenotrophomonas maltophilia (SM) in patients with cystic fibrosis (CF) was associated with accelerated lung function decline and increased hospitalizations. Their findings indicated that acquisition of SM in CF was associated with an acceleration in lung function decline. Moreover, in patients with chronic colonization, the acquisition was also associated with increased hospitalization rates.

Methods

• This study enrolled 88 patients with CF, ages 6–51 years, with first positive respiratory culture for SM between 2008 and 2014.
• With the aid of segmented regression analysis of interrupted time series, rate of decline in FEV₁ and hospitalization rates prior to and following incident SM infection were analyzed.

Results

• Mean (SD) age was 17.4 (9.2) years.
• The mean (SD) FEV₁ % predicted at acquisition was 90.0% (25.2).
• A total of 44% developed chronic SM infection.
• In regression analysis adjusted for clinical and demographic factors, there was worsening of the mean annual decline in FEV1 % predicted from –1.79 (95%CI: –2.43, –1.15) pre–acquisition to –2.14 (95%CI: –2.61, –1.67) post–acquisition (P = 0.005).
• A significant change was observed in those with either subsequent intermittent or chronic infection.
• In the subgroup with chronic infection from 0.46, the mean annual hospitalization rate increased significantly (95%CI: 0.33, 0.60) to 0.88 (95%CI: 0.68, 1.07) (P = 0.007).