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Lower respiratory infection and inflammation in infants with newly diagnosed cystic fibrosis

BMJ 1995; 310 doi: (Published 17 June 1995) Cite this as: BMJ 1995;310:1571
  1. David S Armstrong, fellow in thoracic medicinea,
  2. Keith Grimwood, senior lecturer in paediatricsa,
  3. Rosemary Carzino, research assistanta,
  4. John B Carlin, senior research fellowa,
  5. Anthony Olinsky, director of thoracic medicinea,
  6. Peter D Phelan, professor of paediatricsa
  1. a Departments of Thoracic Medicine and Paediatrics, and Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, University of Melbourne, Parkville 3052, Victoria, Australia
  1. Correspondence to: Dr Grimwood.
  • Accepted 21 March 1995

The nature and timing of lower respiratory infections in infants with cystic fibrosis is largely unknown1 because infants do not produce sputum and throat cultures may not predict lower respiratory pathogens.2 We performed a prospective cross sectional study of an unselected cohort of infants with cystic fibrosis in which bronchoalveolar lavage was used to determine lower respiratory infection and inflammation during the first three months of life.

Patients, methods, and results

The state of Victoria, Australia (66000 births per year) has a cystic fibrosis screening programme, all patients being managed by one centre. Between February 1992 and September 1994 we recruited 45 (27 boys) of the 52 infants with newly diagnosed disease; 32 were identified by screening, 12 from meconium ileus, and one by failure to thrive, and all cases were confirmed by sweat testing. Sixteen infants had respiratory symptoms, and seven of them were receiving oral antibiotics when bronchoalveolar lavage was performed at a mean age of 2.6 (SD 1.6) months. Nine otherwise healthy infants (five boys) aged …

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