Role of respiratory viruses in pulmonary exacerbations in children with cystic fibrosis

Asner, Sandra; Waters, Valerie; Solomon, Melinda; Yau, Yvonne; Richardson, Susan E.; Grasemann, Hartmut; Gharabaghi, Farhad; Tran, Dat

BACKGROUND: The role of respiratory viruses in cystic fibrosis (CF) exacerbations is incompletely understood. METHODS: Cross-sectional study of CF children with a pulmonary exacerbation. Mid-turbinate swabs were tested by a direct immunofluorescent antibody assay and a multiplex PCR panel (ResPlex II v2.0, Qiagen). Resplex II was also applied to sputum or throat swab samples. Pulmonary function tests and quality of life and severity scores were recorded. Sputum cell counts, bacterial density and cytokines were measured. RESULTS: 26/43 (60.5%) subjects tested positive for at least one respiratory virus by any diagnostic method applied to any sample type. Virus-positive patients were younger (p = 0.047), more likely to be male (p = 0.029), and had higher CF clinical severity (p = 0.041) and lower quality of life (physical) scores (p = 0.023) but similar IL-8, neutrophil percentage and elastase levels. CONCLUSIONS: Compared to non-viral exacerbations, viral-related exacerbations were associated with worse severity and quality of life scores but similar pulmonary inflammation.