Journal article
Impact of elexacaftor/tezacaftor/ivacaftor on bacterial cultures from people with cystic fibrosis
Pediatric pulmonology, Vol.58(5), pp.1569-1573
05/2023
DOI: 10.1002/ppul.26362
PMID: 36807558
Appears in UI Libraries Support Open Access
Abstract
Cystic fibrosis transmembrane conductance regulator (CFTR) modulators have shown beneficial effects on both forced expiratory volume in one second (FEV
) and frequency of pulmonary exacerbations in people with cystic fibrosis (CF). These positive outcomes may be related to changes in bacterial colonization within the lungs. Elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) is the first triple therapy CFTR modulator approved for use in people with CF six years and older. This study aimed to determine the impact of ELX/TEZ/IVA on the isolation of Pseudomonas aeruginosa (Pa), methicillin-resistant and methicillin-susceptible Staphylococcus aureus (MRSA and MSSA, respectively) in respiratory cultures.
A retrospective chart review of the electronic medical record at the University of Iowa was completed for individuals 12 years and older taking ELX/TEZ/IVA for at least 12 months. The primary outcome was determined by assessing bacterial cultures pre- and post-initiation of ELX/TEZ/IVA. Baseline demographic and clinical characteristics were summarized using mean and standard deviation for continuous outcomes and count and percentage for categorical outcomes. Culture positivity for Pa, MSSA, and MRSA was compared among enrolled subjects between pre- and post-triple combination therapy periods using an exact McNemar's test.
One hundred twenty-four subjects prescribed ELX/TEZ/IVA for at least 12 months met the requirements for inclusion within our analysis. Culture positivity for Pa, MSSA, and MRSA was approximately 54%, 33%, and 31%, respectively, for the pre-ELX/TEZ/IVA period. Prevalence decreased to approximately 30%, 32%, and 24% [-24.2% (P<0.0001), -0.7% (P=1.00), and -6.5% (P=0.0963) respectively] post-ELX/TEZ/IVA. The source of bacterial culture was predominantly sputum (70.2%) in the pre-ELX/TEZ/IVA group, whereas a throat source (66.1%) was more common post-ELX/TEZ/IVA.
ELX/TEZ/IVA treatment has an appreciable impact on the detection of common bacterial pathogens in CF respiratory cultures. While previous studies have found a similar effect with single and double CFTR modulator therapies, this is the first single-center study to show the impact of triple therapy, ELX/TEZ/IVA, on bacterial isolation from airway secretions. This article is protected by copyright. All rights reserved.
Details
- Title: Subtitle
- Impact of elexacaftor/tezacaftor/ivacaftor on bacterial cultures from people with cystic fibrosis
- Creators
- Michael R Beck - University of Iowa Hospitals and ClinicsDouglas B Hornick - University of IowaTahuanty A Pena - University of Iowa Hospitals and ClinicsSachinkumar B Singh - University of IowaBrittany A Wright - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Pediatric pulmonology, Vol.58(5), pp.1569-1573
- Publisher
- Wiley
- DOI
- 10.1002/ppul.26362
- PMID
- 36807558
- eISSN
- 1099-0496
- Language
- English
- Electronic publication date
- 02/20/2023
- Date published
- 05/2023
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984370966802771
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