PSEUDOMONAS-AERUGINOSA INFECTION IN CYSTIC-FIBROSIS - DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE OF PSEUDOMONAS-AERUGINOSA PRECIPITINS DETERMINED BY MEANS OF CROSSED IMMUNOELECTROPHORESIS

Abstract

A total of 133 patients with cystic fibrosis have been followed for up to 5 yr with monthly examinations including bacteriological examination of sputum. Sera from the patients were examined by means of crossed immunoelectrophoresis for the occurrence and number of precipitating antibody specificies against P. aeruginosa. Poor prognosis in cystic fibrosis was associated with chronic colonization (9 mo. to more than 5 yr) of the respiratory tract with mucoid P. aeruginosa, and with an onset of the chronic colonization before puberty. Among the patients with chronic P. aeruginosa colonization, poor prognosis was associated with high numbers of precipitins against antigens from these bacteria (up to 61). The number of P. aeruginosa precipitins increased on an average with 5/yr in chronically colonized patients. Rapidly increasing number of precipitins was associated with poor prognosis. Patients with any degree of impairment of the ventilatory function and any changes on the chest radiographs could contract chronic P. aeruginosa colonization. Poor ventilatory function and severe changes on the chest radiographs was associated with high numbers of P. aeruginosa precipitins and with poor prognosis. Although many 0 groups of P. aeruginosa were found in the chronically colonized group of patients, 53% of the patients harbored strains belonging to 0 group 3 or 3/9, and the highest numbers of precipitins were found in serum from these patients.