82 Increasing levels of precipitating antibodies to Achromobacter xylosoxidans and Burkholderia multivorans reflect more aggressive pulmonary disease in chronically infected Cystic Fibrosis patients

Abstract

Introduction; Absolute level and rapidly increasing levels of precipitating antibodies to Pseudomonas aeruginosa (PA) in chronic pulmonary infection in cystic fibrosis (CF) are correlated with degree of lung inflammation, tissue damage and poor prognosis. Precipitating antibodies to other Gram-negative bacteria may exhibit similar properties. Aims; To assess the correlation between levels of precipitins to Achromobacter xylosoxidans (AX), and Burkholderia multivorans iBM) and lung function in chronically infected CF patients. Methods: All patients with a diagnosis of chronic infection with either AX or BM as per 2005 were included. The correlation between level of precipitating antibodies and FEV1% predicted was assessed. Results; 14 patients with chronic AX had median (range) FEV1% predicted of 66% (23 to 111%) and precipitin levels of 25 (3 to 40) showing statistically significant, but weak, negative correlation (r2 0.24, p < 0.05). Correspondingly, in 12 patients with chronic BM a statistically significant negative correlation (r2 0.65, p < 0.05) was shown between lung function: 63% (40 to 110%) and precipitin levels: 17 (8 to 25). Conclusion: Chronic infection with AX or BM, like PA, induces increasing levels of precipitins as markers of enhanced tissue damage as reflected in declining lung function. Precipitins to other Gram-negative bacteria than PA may function as markers of infection severity, treatment success or failure. S19