EPS02.5 A new risk factor predicts ABPA in patients with cystic fibrosis

Abstract

Objectives ABPA manifests with poorly controlled obstructive disease, recurrent pulmonary infiltrates with or without bronchiectasis in up to 7% of patients with CF. ABPA causes high morbidity due to long-term corticosteroid therapy and related side effects (e.g. osteoporosis). Concerning the risks of acquisition of ABPA related to domestic pet keeping no data exist for patients with CF. Methods In this study we prospectively collected pet related data from questionnaires and demographic, clinical and microbiological data from the local patient registry (Muko.doc; July 2012-July 2013) for 111 patients with CF: 56 pet owners (POs), 55 non-pet owners (NPOs). Clinical proven ABPA was confirmed according to criteria of the UK Cystic Fibrosis Trust. Results The occurrence of clinical proven ABPA was significantly higher in the PO (23%) cohort than in the cohort of NPOs (8%) as calculated by univariate analysis (p = 0.004). Pet ownership was still the significant predictor for ABPA after adjustment for age, gender and other clinical co-variables in multiple logistic regression analysis (OR 7.307, 95% CI: 1.773–50.127). Furthermore, we could show that lung function is significantly impaired in POs compared to NPOs (p = 0.039; univariate analysis): The mean FEV1% was 64.3% in POs versus 74.4% in NPOs. Discussion This is the first study indicating evidence of domestic pet ownership being a new risk factor for the acquisition of ABPA in patients with CF. We would recommend two major suggestions: 1.to regularly screen for clinical proven ABPA in patients with CF owning a pet and vice versa 2.to screen ABPA patients with CF for pet ownership.