Respiratory tract infection by micro-organisms B. cepacia complex as unfavorable prognostic factor in patients with cystic fibrosis
The aim of the research is to determine the survival rate of patients with cystic fibrosis whose airways are chronically infected with Burkholderia cepacia complex (BCC) compared to patients with cystic fibrosis having another chronic gram-negative infection. Material and methods. The data of adult patients with cystic fibrosis observed in the Research Institute of Pulmonology during 2003-2018 has been analysed. Retrospective longitudinal comparative study was conducted. Two groups of patients were formed: - “non-BCC” group (419 people), which includes patients who are chronically infected by any gram-negative flora, but for BCC, both in monoculture and in combination with each other or with S. aureus. - BCC group (138 people): patients with chronic Burkholderia cepacia complex in monoculture and / or with S. aureus and / or other gram-negative flora. Duration of gram-negative flora infection was determined as the main study parameter of survival analysis. Results. 48.6 % of patients from “BCC” group died, while in “non-BCC” group 25.1 % of patients died. Group “BCC”: the average infection duration (ID) among the living patients was 9.0 ± 2.9 years, among those who died, before death it was 6.6 ± 4.0 years. Non-BCC group: average infection duration among the living patients was 12.4 ± 6.6 years, among those who died, before death it was 11.6 ± 6.8 years. Survival median for BCC group from the infection moment was 11.2 (95 % ID: 9.55-12.85) years, for non-BCC group it was 23.8 (95 % ID: 21.89-25, 71) years. LogRank Test: x2 = 84.1, p <0.001. Conclusion. Respiratory tract infection with pathogens of Burkholderia cepacia complex significantly reduces life expectancy of patients with cystic fibrosis compared to chronic infection with other gram-negative flora. Thus, infection with Burkholderia cepacia complex can be considered as unfavourable prognostic factor for patients with cystic fibrosis.