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The role of respiratory viruses in cystic fibrosis

Wat, Dennis, Gelder, Colin, Hibbitts, Samantha Jayne, Cafferty, Fay, Bowler, Ian, Pierrepoint, Marcus, Evans, Rachel and Doull, Iolo 2008. The role of respiratory viruses in cystic fibrosis. Journal of Cystic Fibrosis 7 (4) , pp. 320-328. 10.1016/j.jcf.2007.12.002

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Background Previous studies have suggested a role played by respiratory viruses in the exacerbation of cystic fibrosis (CF). However, the impact of respiratory viruses could have been underestimated because of the low detection rate by conventional laboratory methods. Methods Children with CF had nasal swabs and sputum samples obtained on a routine basis and when they developed respiratory exacerbations. Nucleic Acid Sequence Based Amplification (NASBA) was used to detect respiratory viruses from nasal swabs. The definition of a respiratory exacerbation was when the symptom score totalled to 4 or more, or if the peak expiratory flow fell by more than 50 l/min from the child's usual best value, or if the parent subjectively felt that the child was developing a cold. Results 71 patients had 165 reported episodes of respiratory exacerbations. 138 exacerbation samples were obtained of which 63 (46%) were positive for respiratory viruses. In contrast, 23 of 136 asymptomatic nasal swabs (16.9%) were positive for respiratory viruses. There was significantly more viruses being detected during respiratory exacerbations, in particular influenza A, influenza B and rhinovirus (p < 0.05). Upper respiratory symptoms significantly correlated with positive respiratory viral detection (p < 0.05). This study also showed that viral respiratory exacerbations in CF could be independent from bacterial infections. Conclusions Respiratory viruses are associated with exacerbations in CF and upper respiratory symptoms are strong predictors for their presence. ‘Real-time’ NASBA has a rapid turn-around time and has the potential to aid clinical decision making, such as the use of anti-virals and administration of antibiotics.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: influenza vaccination, cystic fibrosis, NASBA
Publisher: Elsevier
ISSN: 1569-1993
Last Modified: 28 Jun 2019 02:38

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