57 Does Pandoraea cause clinical deterioration in healthy CF children?

Abstract

Objective and Methods Clinical significance of Pandoraea, a multi drug resistant Gram-negative bacteria, is unknown. A clinical review of 6 CF children who grew Pandoraea in a 2 year period from October 2012 to September 2014 was conducted to answer following questions: (1) Does Pandoraea cause clinical deterioration (as measured by change in FEV1 and BMI) in CF children? (2) To identify most sensitive intravenous antibiotic against Pandoraea . Pt no.Age at first isolationMonths since first growthFEV1 at first growthChange in FEV1 since first growthBMI at first growthChange in BMI since first growthFrequency (Pandoraea/total samples)1736/572946102+ 4%18.88+5.9626/653123878−21%15.91+3.8138/61416997+3%17.18+1.541/265142564−3%16.95+2.0911/266108186+1%17.58+3.002/32 Results See the table. 4 out of 6 children grew Pandoraea frequently. 1 child had the first growth recently, but since the first growth, grew Pandoraea in all samples. 4 out of 5 children had stable or higher lung function 3 years after the first growth. Only child who had a drop in lung function of 21% since first isolation of Pandoraea had poor compliance to treatment and was colonised with Pseudomonas aeruginosa (PA), while others were either PA free or grew PA intermittently. BMI increased by a mean of 19% in 3 years since first growth. Imipenem was the most sensitive Intra Venous antibiotic, followed by Tazocin. Ciprofloxacin was found to be intermittently sensitive. Conclusion In 4 out of 5 children, Pandoraea was not found to cause clinical deterioration, as measured by change in lung function and BMI. Imipenem was the most sensitive antibiotic against Pandoraea .