MUCOID PSEUDOMONAS-AERUGINOSA IS A MARKER OF POOR SURVIVAL IN CYSTIC-FIBROSIS

The aim of this study was to assess the prognostic significance of muc oid and non-mucoid isolates of Pseudomonas aeruginosa (muPs and non-mu Ps) from the sputa of patients with cystic fibrosis (CF). Eighty-one c hildren with CF who coughed up sputum daily were recruited and followe d over 12 months with frequent sputum cultures. At the end of this obs ervation period they were classified to one of three age-matched group s. In 50 mPs was isolated on one or more occasions; 19 grew non-muPs b ut not muPs, and 12 grew no isolates of Ps aeruginosa. These 81 childr en and adolescents were followed for a further 8 years or until they d ied. Twenty-one (42%) of the muPs patients died compared with two (11% ) of the non-muPs and one (8%) of the no Ps patients (P < 0.01). Stepw ise regression indicated that forced expiratory volume in 1 second (FE V1) had the main predictive effect but that age, Shwachman score and m uPs also had a predictive effect. Identification of mucoid forms of Ps aeruginosa is an unfavorable prognostic factor but the isolation of n on-mucoid strains does not appear to be any more important than the is olation of other common respiratory pathogens.