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• W1998141338 abstract "To the Editor:Farrell's contribution discusses the risks and benefits of cystic fibrosis (CF) neonatal screening. The authors underline that Pseudomonas aeruginosa (Pa) acquisition seems unrelated to the screening but related to exposures associated with healthcare services.1.Farrell P.M. Farrell M.H. Newborn screening for cystic fibrosis: ensuring more good than harm.J Pediatr. 2003; 143: 707-712Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar Currently there are few data regarding Pa acquisition in screened newborns.2.Farrell P.M. Shen G. Splaingard M. Colby C.E. Laxova A. Kosorok M.R. et al.Acquisition of Pseudomonas aeruginosa in children with cystic fibrosis.Pediatrics. 1997; 100: e2Crossref PubMed Scopus (109) Google Scholar, 3.Wang S.S. FitzSimmons S.C. O'Leary L.A. Rock M.J. Gwinn M.L. Khoury M.J. Early diagnosis of cystic fibrosis in the newborn period and risk of Pseudomonas aeruginosa acquisition in the first 10 years of life: a registry-based longitudinal study.Pediatrics. 2001; 107: 274-279Crossref PubMed Scopus (47) Google Scholar, 4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar In our CF Center, 28 patients were diagnosed by screening before implementation of the Pa infection control policy (1984-1991, mean age [± SD] at the end of the period 33.6 ± 28.8 months). Forty-seven patients were diagnosed by screening in the period 1992 to 2002 (mean age [± SD] at the end of the period 52.5 ± 36.2 months) after the introduction of the following procedures: patient segregation, strict observance of behavioral rules, daily disinfection of rooms and medical equipment, and early eradication treatment at first Pa isolation.4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar, 5.Valerius N.H. Koch C. Høiby N. Prevention of chronic Pseudomonas aeruginosa colonisation in cystic fibrosis by early treatment.Lancet. 1991; 338: 725-726Abstract PubMed Scopus (434) Google Scholar, 6.Taccetti G. Repetto T. Procopio E. Farina S. Campana S. Early Pseudomonas aeruginosa colonisation in cystic fibrosis patients.Lancet. 2002; 359: 625-626Abstract Full Text Full Text PDF PubMed Google ScholarIn the period 1984 to 1991, the mean age [± SD] at the time of first positive culture for Pa was 16.4 ± SD 15.4 months and the incidence of first colonizations (expressed as positive cultures/months free from the germ × patient × 100) was 3.59%.4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google ScholarAfter introduction of the infection control policy, the mean age (± SD) at first Pa isolation was 21.1 ± SD 21 months and the incidence of first colonizations was 2.49% (RR, 0.69).4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar Initial Pa colonization occurred in 21 (44.6%) patients. All underwent early eradication therapy that succeeded in 15 (71.4%) patients. Currently, only 6 (12.7%) of 47 patients are chronically colonized by Pa.4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar, 6.Taccetti G. Repetto T. Procopio E. Farina S. Campana S. Early Pseudomonas aeruginosa colonisation in cystic fibrosis patients.Lancet. 2002; 359: 625-626Abstract Full Text Full Text PDF PubMed Google ScholarFurthermore, at age 15, only 37.5% of patients diagnosed by screening are chronically colonized by Pa versus 64.1 % of patients diagnosed by symptoms.Diagnosis by neonatal screening improves many health outcomes1.Farrell P.M. Farrell M.H. Newborn screening for cystic fibrosis: ensuring more good than harm.J Pediatr. 2003; 143: 707-712Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar of CF patients in the first decade of life and allows a better microbiological surveillance. Because Pa strongly influences lung disease severity, our data confirm that neonatal screening, together with patient segregation and early Pa eradication, delay chronic colonization and help alleviate lung disease. To the Editor: Farrell's contribution discusses the risks and benefits of cystic fibrosis (CF) neonatal screening. The authors underline that Pseudomonas aeruginosa (Pa) acquisition seems unrelated to the screening but related to exposures associated with healthcare services.1.Farrell P.M. Farrell M.H. Newborn screening for cystic fibrosis: ensuring more good than harm.J Pediatr. 2003; 143: 707-712Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar Currently there are few data regarding Pa acquisition in screened newborns.2.Farrell P.M. Shen G. Splaingard M. Colby C.E. Laxova A. Kosorok M.R. et al.Acquisition of Pseudomonas aeruginosa in children with cystic fibrosis.Pediatrics. 1997; 100: e2Crossref PubMed Scopus (109) Google Scholar, 3.Wang S.S. FitzSimmons S.C. O'Leary L.A. Rock M.J. Gwinn M.L. Khoury M.J. Early diagnosis of cystic fibrosis in the newborn period and risk of Pseudomonas aeruginosa acquisition in the first 10 years of life: a registry-based longitudinal study.Pediatrics. 2001; 107: 274-279Crossref PubMed Scopus (47) Google Scholar, 4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar In our CF Center, 28 patients were diagnosed by screening before implementation of the Pa infection control policy (1984-1991, mean age [± SD] at the end of the period 33.6 ± 28.8 months). Forty-seven patients were diagnosed by screening in the period 1992 to 2002 (mean age [± SD] at the end of the period 52.5 ± 36.2 months) after the introduction of the following procedures: patient segregation, strict observance of behavioral rules, daily disinfection of rooms and medical equipment, and early eradication treatment at first Pa isolation.4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar, 5.Valerius N.H. Koch C. Høiby N. Prevention of chronic Pseudomonas aeruginosa colonisation in cystic fibrosis by early treatment.Lancet. 1991; 338: 725-726Abstract PubMed Scopus (434) Google Scholar, 6.Taccetti G. Repetto T. Procopio E. Farina S. Campana S. Early Pseudomonas aeruginosa colonisation in cystic fibrosis patients.Lancet. 2002; 359: 625-626Abstract Full Text Full Text PDF PubMed Google Scholar In the period 1984 to 1991, the mean age [± SD] at the time of first positive culture for Pa was 16.4 ± SD 15.4 months and the incidence of first colonizations (expressed as positive cultures/months free from the germ × patient × 100) was 3.59%.4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar After introduction of the infection control policy, the mean age (± SD) at first Pa isolation was 21.1 ± SD 21 months and the incidence of first colonizations was 2.49% (RR, 0.69).4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar Initial Pa colonization occurred in 21 (44.6%) patients. All underwent early eradication therapy that succeeded in 15 (71.4%) patients. Currently, only 6 (12.7%) of 47 patients are chronically colonized by Pa.4.Festini F. Taccetti G. Campana S. Cioni M.L. Ravenni N. de Martino M. Efficacy of a combined policy of segregation and early eradication treatment for P. aeruginosa in a population of CF patients diagnosed by screening.Pediatr Pulmonol. 2003; : 302PubMed Google Scholar, 6.Taccetti G. Repetto T. Procopio E. Farina S. Campana S. Early Pseudomonas aeruginosa colonisation in cystic fibrosis patients.Lancet. 2002; 359: 625-626Abstract Full Text Full Text PDF PubMed Google Scholar Furthermore, at age 15, only 37.5% of patients diagnosed by screening are chronically colonized by Pa versus 64.1 % of patients diagnosed by symptoms. Diagnosis by neonatal screening improves many health outcomes1.Farrell P.M. Farrell M.H. Newborn screening for cystic fibrosis: ensuring more good than harm.J Pediatr. 2003; 143: 707-712Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar of CF patients in the first decade of life and allows a better microbiological surveillance. Because Pa strongly influences lung disease severity, our data confirm that neonatal screening, together with patient segregation and early Pa eradication, delay chronic colonization and help alleviate lung disease. We thank Telethon Foundation Italy for Grant GP 205Y02-2002. ReplyThe Journal of PediatricsVol. 145Issue 3Preview Full-Text PDF" @default.
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