Epidemiology of respiratory infections in Cystic Fibrosis patients at Hospital Nacional Edgardo Rebagliati Martins

Abstract

Cystic Fibrosis is a genetic disease whose incidence is not yet known in our country. Patients suffer from suffer from chronic endobronchial infection, which is the leading cause of morbidity and mortality. Objectives: To determine the epidemiological characteristics of the respiratory infections in patients with Cystic Fibrosis of our hospital, to identify the most common germs, to understand their behavior and the causes of death. Material and methods: A prospective longitudinal and observational study was carried out which included 20 patients with Cystic Fibrosis diagnosis, who received medical treatment in the Pediatric Neumonology Unit of the Hospital Nacional Edgardo Rebagliati Martins, from 2000 to 2007. The age, the initial infectious germ, the average of the obtained culture in the different hospitalizations or in outpatient consultations, the prevailing germs, the causes and age of death were evaluated. Results: During this period, 20 patients were treated, the age was an average of 6 ± 3.7 years and 65% were males. The initial infectious germ was Pseudomona aeruginosa with a 35.0%, followed by Staphylococcus aureus in 25% of the cases, being the starting age of the infection for Pseudomona aeruginosa between 14 months, with an average age of 49+/-32.3 months. The causing germ of the chronic colonization was Pseudomona aeruginosa in the 46% of the cases. An average of 3.2 positive cultures of Pseudomona aeruginosa was found during the hospitalizations, followed by infection of Staphylococcus aureus, with an average of 2.2 cultures. There were also found an average of 2.7 cultures to Pseudomona aeruginosa during the exacerbations treated in ambulatory care, however negative cultures during hospitalization (an average of 0.4 vs. an average of 18.8) were observed. The average number of hospitalization during this period is was 5.4 ambulatory care as a cause of exacerbation was of 7.7 times. The cause of death was due to respiratory insufficiency related to sepsis to Pseudomona aeruginosa in the 72.0% of the cases, being children from 1 to 3 years of age the most affected (100%). Conclusions: The initial infectious germ in patients with Cystic Fibrosis was in the most frequent cases Pseudomona aeruginosa, taking place at early ages in our hospital, which is different from what is written in books, and it is also the leading cause of chronic respiratory infections, which causes more morbidity and mortality in these patients.