Clinical characteristics and outcomes associated with Inquilinus infection in cystic fibrosis

      Highlights

      • Summary of clinical significance of Inquilinus infection in 17 persons with CF.
      • Initial Inquilinus infection was detected exclusively in children and young adults.
      • Most cases had chronic rather than transient Inquilinus infection.
      • Inquilinus infection was associated with low and declining lung function.
      • 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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