46 Microbiological airway flora in children with cystic fibrosis in the first year of life (To treat or not to treat, that's the question!)

Abstract

In children with cystic fibrosis (CF) pulmonary microbial colonization and infection are important prognostic factors. In Germany a national CF newborn screening does not exist by now and only little is known about the microbial respiratory flora of children with CF in the first years of life. In Dresden a regional newborn screening program for eastern Saxony exists since 1996. Thus, a microbiological monitoring for patients with CF was already performed from diagnosis in the first month of life throughout babyhood and we collected data from 1997 on. In the following, we want to demonstrate the microbial colonization of 55 patients in our center in their first year of life. In all patients we found bacteria other than normal flora of mouth and throat. Most commonly we detected Staphylococcus aureus, Haemophilus influenzae and Escherichia coli, but also a variety of many other such as Klebsiella, Serratia, Streptococcus, Enterobacter, Enterococcus and Acinetobacter species, Bacillus cereus, Branhamella catarrhalis, and more. We also detected Pseudomonas aeruginosa and other Pseudomonas species already in patients at this young age. In several patients we found fungi in the throat swab, such as Aspergillus , Candida and Saccharomyces species. Most of the patients needed antibiotic therapy in their first year of life due to pulmonary exacerbation, but the clinical symptoms in many cases did not correlate with the microbiological findings by throat swab. With the introduction of a national newborn screening program for CF hopefully end of this year, we will have to discuss the influence of these bacterial findings in the first year of life on the prognosis and the need for treatment.