Risk factors for age at initial Pseudomonas acquisition in the cystic fibrosis epic observational cohort

Margaret Rosenfeld, Julia Emerson, Sharon McNamara, Valeria Thompson, Bonnie W. Ramsey, Wayne J Morgan, Ronald L. Gibson

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Background: Risk factors for initial Pseudomonas aeruginosa (Pa) acquisition, particularly environmental exposures, are poorly understood. We aimed to identify such risk factors in order to inform prevention strategies and identify high-risk populations. Methods: The study cohort included all participants in the U.S. EPIC Observational Study who had no prior Pa-positive respiratory cultures (N. =889). Cox proportional hazard models were used to test the effects of factors on age at first Pa-positive respiratory culture. Results: Cystic fibrosis (CF) genotype functional class had an important effect on age at initial Pa acquisition (hazard ratio (HR) comparing minimal to residual CFTR function 2.87 (95% CI 1.88, 4.39)). None of the modifiable risk factors evaluated, including cigarette smoke, hot tub use, breastfeeding, or daycare, was associated with age at Pa acquisition. Similarly, newborn screening was not associated with age at Pa acquisition (HR 0.85, 95% CI 0.66, 1.09). Key associations were validated in a CF Foundation National Patient Registry replication cohort. Conclusions: Given the ubiquitous presence of Pa in the environment, it may be that many imposed lifestyle changes will have less impact on age at initial Pa acquisition than genetic determinants.

Original languageEnglish (US)
Pages (from-to)446-453
Number of pages8
JournalJournal of Cystic Fibrosis
Volume11
Issue number5
DOIs
StatePublished - Sep 2012

Fingerprint

Pseudomonas
Cystic Fibrosis
Pseudomonas aeruginosa
Age Factors
Environmental Exposure
Breast Feeding
Proportional Hazards Models
Smoke
Tobacco Products
Observational Studies
Registries
Life Style
Cohort Studies
Genotype
Newborn Infant
Population

Keywords

  • Cystic fibrosis
  • Environment
  • Epidemiology
  • Exposure
  • Pseudomonas
  • Risk factors

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Risk factors for age at initial Pseudomonas acquisition in the cystic fibrosis epic observational cohort. / Rosenfeld, Margaret; Emerson, Julia; McNamara, Sharon; Thompson, Valeria; Ramsey, Bonnie W.; Morgan, Wayne J; Gibson, Ronald L.

In: Journal of Cystic Fibrosis, Vol. 11, No. 5, 09.2012, p. 446-453.

Research output: Contribution to journalArticle

Rosenfeld, Margaret ; Emerson, Julia ; McNamara, Sharon ; Thompson, Valeria ; Ramsey, Bonnie W. ; Morgan, Wayne J ; Gibson, Ronald L. / Risk factors for age at initial Pseudomonas acquisition in the cystic fibrosis epic observational cohort. In: Journal of Cystic Fibrosis. 2012 ; Vol. 11, No. 5. pp. 446-453.
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