Highlights
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•
Summary of clinical significance of Inquilinus infection in 17 persons with CF.
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Initial Inquilinus infection was detected exclusively in children and young adults.
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Most cases had chronic rather than transient Inquilinus infection.
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Inquilinus infection was associated with low and declining lung function.
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Inquilinus cases had similar outcomes as controls with chronic P. aeruginosa.
Abstract
Background
Molecular diagnostics have led to the identification of a broad range of bacterial
species in cystic fibrosis (CF) including
Inquilinus. The clinical significance of
Inquilinus in CF has not been thoroughly characterized.
Methods
Retrospective, case-control study of persons with CF from two CF centers with at least
one respiratory culture positive for
Inquilinus spp
. compared with age-matched CF controls with chronic
Pseudomonas aeruginosa. Percent predicted forced expiratory volume in one second (ppFEV1) and body mass index
percentile (BMI) were modeled from time of first positive culture up to 5 years later.
Rates of pulmonary exacerbations were compared.
Inquilinus isolates were genotyped to evaluate strain diversity.
Results
Seventeen patients with
Inquilinus infection were identified with a mean age of 13 years at first positive culture.
Most cases had multiple cultures positive for
Inquilinus. ppFEV1 was not different between cases versus controls (80.2% vs 81.6%,
p = 0.97 at baseline, 67.5% vs. 73.3%,
p = 0.82 at 5 years). Patients were undernourished and BMI percentiles did not differ
between groups (30.7% vs 43.4%,
p = 0.32 at baseline, 37.9% vs. 37.6%,
p = 0.98 at 5 years). There was no difference in the pulmonary exacerbation rate (3.0/year
vs 2.5/year,
p = 0.34). Genotyping showed diverse genetic strains between patients.
Conclusions
Inquilinus can present in childhood and is often associated with chronic infection in CF. Lung
function and nutrition status at time of detection, lung function decline, and pulmonary
exacerbation rates in
Inquilinus cases were similar to those with chronic
P. aeruginosa, a well-established CF pathogen.
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Article Info
Publication History
Published online: July 31, 2020
Accepted:
July 20,
2020
Received in revised form:
July 16,
2020
Received:
May 18,
2020
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2020 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.