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- W3159867898 abstract "Acinetobacter baumannii has emerged as a challenging pathogen for many institutions globally. While its recognition as a multidrug-resistant organism is growing, there remains limited literature documenting the disease burden in patients with cystic fibrosis (CF).1 An analysis of isolates referred to by the Burkholderia cepacia Research Laboratory and Repository (University of Michigan) identified A. baumannii in specimens from only five US CF patients between 2004 and 2008.2 The analysis did not provide details on whether these were adult or paediatric patients, thus highlighting the paucity of literature describing the clinical course of A. baumannii isolation in CF patients. In light of the paucity of literature, we write to illustrate the clinical impact of A. baumannii infection in a paediatric patient with CF. The patient, who is heterozygous for G27X/2622 + 1G > A mutation, attended a routine clinic in June 2018 with weight loss, ppFEV1 below baseline and an increased Lung Clearance Index (LCI). A cough swab was positive for A. baumannii. Despite efforts to establish an appropriate eradication regime, there was mounting evidence that infection with A. baumannii was having a negative impact on our patient's clinical status, with a persistent cough and poor weight gain (Fig. 1). In addition, analysis of data from multiple breath washouts showed that there were variations in the LCI values at multiple time points (Fig. 1). LCI values are produced from multiple breath washouts detecting subtle changes in the small airways.3 Following a third, more prolonged eradication regime (ciprofloxacin (20 mg/kg per dose given twice daily orally) for 4 weeks and tobramycin for inhalation (300 mg nebulised twice daily) for 4 weeks), there was a resolution of the cough, an eradication of organism on swab and an improvement in measured clinical parameters (Fig. 1). It is therefore reasonable to assume that A. baumannii has an occult, pathogen-mediated, impact on the small airways resulting in clinical symptoms and reduced ventilation homogeneity in paediatric patients with CF. This clinical course suggests that when A. baumannii becomes established in the CF airway it can act as a pathogen, rather than coloniser, warranting aggressive treatment to eradicate. This information is of value to paediatric physicians caring for children with CF world-wide. Written informed consent was obtained from the patient's mother to publish this case." @default.
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- W3159867898 date "2021-04-30" @default.
- W3159867898 modified "2023-09-26" @default.
- W3159867898 title "Acinetobacter baumannii Infection in a Child with Cystic Fibrosis" @default.
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- W3159867898 doi "https://doi.org/10.1111/jpc.15536" @default.
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