Acute severe deterioration in cystic fibrosis associated with influenza A virus infection.

SUMMARYViral infections are associated with pulmonary exacerbations in children with cystic fibrosis (CF), but few studies have addressed the frequency in adults. This paper investigates the frequency and impact of viral infections in adults with CF receiving intravenous antibiotics. Pre-and posttreatment spirometry, inflammatory markers and antibody titres against influenza A, influenza B, adenovirus, respiratory syncytial virus, Mycoplasma pneumoniae, Chlamydia psittaci, and Coxiella burnetti were analysed over a 10-year period. Non-bacterial infections were identified in 5 . 1% of 3156 courses of treatment. The annual incidence of admissions per patient associated with viral infection was 4 . 9 %. The presence of viral infection in association with a pulmonary exacerbation did not adversely affect lung function or inflammatory markers in the short term. Adults with CF have a lower incidence of respiratory viral infections associated with pulmonary exacerbations requiring intravenous antibiotics compared to children and infants with CF.

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“…Respiratory viral infections may be associated with significant clinical deterioration [2] and predispose to infection with P. aeruginosa [3].…”

Section: Introductionmentioning

confidence: 99%

Ten years of viral and non-bacterial serology in adults with cystic fibrosis

et al. 2007

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“…Infections with respiratory viruses (eg, influenza and rhinoviruses) are associated with exacerbation of pulmonary problems, disease progression, and increase in bacterial adherence in CF airways, which predisposes to secondary bacterial infection. [7][8][9][10] Once infected with respiratory viruses, children with CF are affected for longer periods and more severely than healthy children. 11 During the influenza pandemic, patients with CF had an increased morbidity and a higher case fatality compared with patients with other chronic respiratory diseases or to healthy control subjects.…”

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confidence: 99%

Safety of Live-Attenuated Influenza Vaccination in Cystic Fibrosis

et al. 2014

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OBJECTIVES: Given the improved efficacy of the nasal live-attenuated influenza virus vaccine (LAIV) compared with the injectable vaccine in children, we aimed to determine its safety in individuals with cystic fibrosis (CF). METHODS: A cohort of 168 study participants, aged 2 to 18 years with CF, vaccinated with LAIV between October 1, 2012, and January 30, 2013, was followed prospectively for 56 days after initial vaccination in 3 pediatric CF clinics across the province of Quebec. Days 0 to 28 post-LAIV were considered the at-risk period for all outcomes of interest, and days 29 to 56 post-LAIV were considered the non–at-risk period. Incident respiratory deteriorations were defined as an unscheduled medical visit, hospitalization, or a new course of oral antibiotics for respiratory complaints. Using a self-controlled design, incidence rate ratios (IRR) were used to compare at-risk and non–at-risk periods. RESULTS: Comparing at-risk to non–at-risk periods, there was no significant increase in the rate of incident respiratory deteriorations (IRR, 0.72; 95% confidence interval, 0.11–4.27) or all-cause hospitalizations (IRR, 1.16; 95% confidence interval, 0.30–4.81). A greater proportion of participants reported experiencing at least 1 minor respiratory and/or systemic adverse event after immunization during the at-risk period compared with the non–at-risk period (77% vs 54%, respectively). During the first week after LAIV, 13 of 168 (8%) children reported some wheezing, with the vast majority, 9 of 13 (69%), on the day of vaccination. CONCLUSIONS: There was no increased risk of respiratory deterioration or all-cause hospitalization associated with LAIV in our study population. LAIV seems well tolerated in children and adolescents with CF.

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“…There were also a higher proportion of patients with a greater than 20% drop in FEV 1 within the influenza infected cohort. A retrospective study in older patients with chronic P. aeruginosa infection reported an acute deterioration in clinical status in association with influenza A virus infection (Conway, Simmonds et al 1992). …”

Section: Viral Respiratory Infections In Cfmentioning

confidence: 99%

Viral Respiratory Tract Infections in Cystic Fibrosis

Wat¹

2012

Cystic Fibrosis - Renewed Hopes Through Research

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Acute severe deterioration in cystic fibrosis associated with influenza A virus infection.

Cited by 72 publications

References 17 publications

Ten years of viral and non-bacterial serology in adults with cystic fibrosis

Ten years of viral and non-bacterial serology in adults with cystic fibrosis

Safety of Live-Attenuated Influenza Vaccination in Cystic Fibrosis

Viral Respiratory Tract Infections in Cystic Fibrosis

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