Clinical outcome in relation to care in centres specialising in cystic fibrosis

BMJ 1999;318:58 ( 2 January )

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Clinical outcome in relation to care in centres specialising in cystic fibrosis

Cross infection with Pseudomonas aeruginosa is unusual

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Cross infection with Pseudomonas aeruginosa is unusual

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EDITOR $---$ Mahadeva et al's paper provides valuable evidence of benefit for paediatric and adult patients attending specialisedcystic fibrosis centres.¹ Their conclusion, however, that themean age at colonisation with Pseudomonas aeruginosa is lowerin patients who received paediatric and adult care in a centre(11.1 years; group A) than in patients who received adult butnot paediatric care in a centre (18.1 years; group B) cannot beaccepted on the basis of the datapresented.

Early detection of infection with P aeruginosa is a major preoccupation for staff working in paediatric cystic fibrosis centres.Colonisation is associated with a rapid decline in pulmonary function,but it can often be delayed or prevented,² and long term useof nebulised antibiotics improves the prognosis if it does occur.³

Mahadeva et al define colonisation using sputum culture. Most young children with cystic fibrosis are unable to produce sputumso that paediatricians have had . . . [Full text of this article]

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Clinical outcome in relation to care in centres specialising in cystic fibrosis: cross sectional study • Commentary: Management in paediatric and adult cystic fibrosis centres improves clinical outcome: Ravi Mahadeva, Kevin Webb, Roger C Westerbeek, Nick R Carroll, Mary E Dodd, Diana Bilton, David A Lomas, and J A Dodge
BMJ 1998 316: 1771-1775. [Abstract] [Full Text] [PDF]