Serology as a diagnostic tool for predicting initialPseudomonas aeruginosa acquisition in childrenwith cystic fibrosis

for the EPIC Investigators

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Rationale: Pseudomonas aeruginosa (Pa) serology could potentially be a useful adjunct to respiratory culture methods for the detection of initial or early Pa infection in patients with cystic fibrosis (CF). Objective: To evaluate the utility of Pa serology to predict Pa isolation from respiratory (generally oropharyngeal) cultures in the subsequent 6 or 12. months among young children with CF from whom Pa had never been previously cultured. Pa serology was also evaluated in a group of healthy controls. Methods: Children≤12years of age without prior isolation of Pa from respiratory cultures participating in the Early Pseudomonal Infection Control EPIC Observational Study (EPIC OBS) had annual serum samples for measurement of antibodies against alkaline protease, elastase and exotoxin A using a commercial kit; controls had a single serum sample. Logistic regression with generalized estimating equations was used to characterize associations between log10 serum antibody titers and first isolation of Pa from a respiratory culture within the subsequent 6 or 12months, with adjustment for sex and age. Receiver operating characteristic curves were used to optimize antibody titer cutpoints by age group. The diagnostic properties of each antibody were estimated using these optimized cutpoints. Results: Pa serology was evaluated in 582 children with CF (2084 serum samples) and 94 healthy controls. There was substantial overlap between serum antibody titers among controls, CF patients who did not acquire Pa (N = 261) and CF patients who did acquire Pa (N = 321). The maximum positive predictive value for first Pa positive culture within the ensuing 6. months was 76.2% and maximum negative predictive value was 72.1% for any antigen or combination of antigens; values were similar for 12. months. Conclusions: Pa serology does not appear useful for predicting first Pa positive oropharyngeal culture among young CF patients.

Original languageEnglish (US)
Pages (from-to)542-549
Number of pages8
JournalJournal of Cystic Fibrosis
Volume13
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Serology
Cystic Fibrosis
Pseudomonas aeruginosa
Antibodies
Serum
Antigens
Pseudomonas Infections
Exotoxins
Infection Control
ROC Curve
Observational Studies
Age Groups
Logistic Models

Keywords

  • Cystic fibrosis
  • Pseudomonas
  • ROC curves
  • Serology

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Serology as a diagnostic tool for predicting initialPseudomonas aeruginosa acquisition in childrenwith cystic fibrosis. / for the EPIC Investigators.

In: Journal of Cystic Fibrosis, Vol. 13, No. 5, 2014, p. 542-549.

Research output: Contribution to journalArticle

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title = "Serology as a diagnostic tool for predicting initialPseudomonas aeruginosa acquisition in childrenwith cystic fibrosis",
abstract = "Rationale: Pseudomonas aeruginosa (Pa) serology could potentially be a useful adjunct to respiratory culture methods for the detection of initial or early Pa infection in patients with cystic fibrosis (CF). Objective: To evaluate the utility of Pa serology to predict Pa isolation from respiratory (generally oropharyngeal) cultures in the subsequent 6 or 12. months among young children with CF from whom Pa had never been previously cultured. Pa serology was also evaluated in a group of healthy controls. Methods: Children≤12years of age without prior isolation of Pa from respiratory cultures participating in the Early Pseudomonal Infection Control EPIC Observational Study (EPIC OBS) had annual serum samples for measurement of antibodies against alkaline protease, elastase and exotoxin A using a commercial kit; controls had a single serum sample. Logistic regression with generalized estimating equations was used to characterize associations between log10 serum antibody titers and first isolation of Pa from a respiratory culture within the subsequent 6 or 12months, with adjustment for sex and age. Receiver operating characteristic curves were used to optimize antibody titer cutpoints by age group. The diagnostic properties of each antibody were estimated using these optimized cutpoints. Results: Pa serology was evaluated in 582 children with CF (2084 serum samples) and 94 healthy controls. There was substantial overlap between serum antibody titers among controls, CF patients who did not acquire Pa (N = 261) and CF patients who did acquire Pa (N = 321). The maximum positive predictive value for first Pa positive culture within the ensuing 6. months was 76.2{\%} and maximum negative predictive value was 72.1{\%} for any antigen or combination of antigens; values were similar for 12. months. Conclusions: Pa serology does not appear useful for predicting first Pa positive oropharyngeal culture among young CF patients.",
keywords = "Cystic fibrosis, Pseudomonas, ROC curves, Serology",
author = "{for the EPIC Investigators} and Daines, {Cori L} and Donald VanDeVanter and Umer Khan and Julia Emerson and Sonya Heltshe and Sharon McNamara and Michael Anstead and Markus Langkamp and Gerd Doring and Felix Ratjen and Bonnie Ramsey and Gibson, {Ronald L.} and Morgan, {Wayne J} and Margaret Rosenfeld",
year = "2014",
doi = "10.1016/j.jcf.2014.06.005",
language = "English (US)",
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T1 - Serology as a diagnostic tool for predicting initialPseudomonas aeruginosa acquisition in childrenwith cystic fibrosis

AU - for the EPIC Investigators

AU - Daines, Cori L

AU - VanDeVanter, Donald

AU - Khan, Umer

AU - Emerson, Julia

AU - Heltshe, Sonya

AU - McNamara, Sharon

AU - Anstead, Michael

AU - Langkamp, Markus

AU - Doring, Gerd

AU - Ratjen, Felix

AU - Ramsey, Bonnie

AU - Gibson, Ronald L.

AU - Morgan, Wayne J

AU - Rosenfeld, Margaret

PY - 2014

Y1 - 2014

N2 - Rationale: Pseudomonas aeruginosa (Pa) serology could potentially be a useful adjunct to respiratory culture methods for the detection of initial or early Pa infection in patients with cystic fibrosis (CF). Objective: To evaluate the utility of Pa serology to predict Pa isolation from respiratory (generally oropharyngeal) cultures in the subsequent 6 or 12. months among young children with CF from whom Pa had never been previously cultured. Pa serology was also evaluated in a group of healthy controls. Methods: Children≤12years of age without prior isolation of Pa from respiratory cultures participating in the Early Pseudomonal Infection Control EPIC Observational Study (EPIC OBS) had annual serum samples for measurement of antibodies against alkaline protease, elastase and exotoxin A using a commercial kit; controls had a single serum sample. Logistic regression with generalized estimating equations was used to characterize associations between log10 serum antibody titers and first isolation of Pa from a respiratory culture within the subsequent 6 or 12months, with adjustment for sex and age. Receiver operating characteristic curves were used to optimize antibody titer cutpoints by age group. The diagnostic properties of each antibody were estimated using these optimized cutpoints. Results: Pa serology was evaluated in 582 children with CF (2084 serum samples) and 94 healthy controls. There was substantial overlap between serum antibody titers among controls, CF patients who did not acquire Pa (N = 261) and CF patients who did acquire Pa (N = 321). The maximum positive predictive value for first Pa positive culture within the ensuing 6. months was 76.2% and maximum negative predictive value was 72.1% for any antigen or combination of antigens; values were similar for 12. months. Conclusions: Pa serology does not appear useful for predicting first Pa positive oropharyngeal culture among young CF patients.

AB - Rationale: Pseudomonas aeruginosa (Pa) serology could potentially be a useful adjunct to respiratory culture methods for the detection of initial or early Pa infection in patients with cystic fibrosis (CF). Objective: To evaluate the utility of Pa serology to predict Pa isolation from respiratory (generally oropharyngeal) cultures in the subsequent 6 or 12. months among young children with CF from whom Pa had never been previously cultured. Pa serology was also evaluated in a group of healthy controls. Methods: Children≤12years of age without prior isolation of Pa from respiratory cultures participating in the Early Pseudomonal Infection Control EPIC Observational Study (EPIC OBS) had annual serum samples for measurement of antibodies against alkaline protease, elastase and exotoxin A using a commercial kit; controls had a single serum sample. Logistic regression with generalized estimating equations was used to characterize associations between log10 serum antibody titers and first isolation of Pa from a respiratory culture within the subsequent 6 or 12months, with adjustment for sex and age. Receiver operating characteristic curves were used to optimize antibody titer cutpoints by age group. The diagnostic properties of each antibody were estimated using these optimized cutpoints. Results: Pa serology was evaluated in 582 children with CF (2084 serum samples) and 94 healthy controls. There was substantial overlap between serum antibody titers among controls, CF patients who did not acquire Pa (N = 261) and CF patients who did acquire Pa (N = 321). The maximum positive predictive value for first Pa positive culture within the ensuing 6. months was 76.2% and maximum negative predictive value was 72.1% for any antigen or combination of antigens; values were similar for 12. months. Conclusions: Pa serology does not appear useful for predicting first Pa positive oropharyngeal culture among young CF patients.

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KW - ROC curves

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