Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 888-895 (doi:10.1542/peds.2004-2599)

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Baussano, I. Articles by Bignamini, E. Search for Related Content PubMed PubMed Citation Articles by Baussano, I. Articles by Bignamini, E. Related Collections Respiratory Tract Social Bookmarking                         What's this?

ARTICLE

Neonatal Screening for Cystic Fibrosis Does Not Affect Time to First Infection With Pseudomonas aeruginosa

Iacopo Baussano, MD, MSc^a,b, Irene Tardivo, MD^b, Rossana Bellezza-Fontana, MD^b, Maria Pia Forneris, BSc^b, Antonella Lezo, MD^b, Luciano Anfossi, MD^b, Mario Castello, MD^b, Veljkovic Aleksandar, MD^b and Elisabetta Bignamini, MD^b

^a Cancer Epidemiology Unit, CPO Piemonte, CeRMS, University of Turin, Turin, Italy
^b Pediatric Cystic Fibrosis Regional Reference Unit, ASO OIRM-Sant’Anna, Turin, Italy

OBJECTIVE. Newborn screening for cystic fibrosis was introduced in the Piedmont region of Italy in the year 2000. Our aim with this study was to estimate the effect of newborn screening on the risk of Pseudomonas aeruginosa infection at the regional cystic fibrosis pediatric reference center.

METHODS. The time to first infection with P aeruginosa within the historical cohort of cystic fibrosis children diagnosed between January 1, 1997, and June 30, 2004, was investigated, comparing survival functions and the adjusted hazard ratio of children diagnosed before and after newborn screening introduction. The role of pancreatic insufficiency was also concurrently investigated.

RESULTS. Overall, 71 children diagnosed with cystic fibrosis were identified, 27 cases were clinically diagnosed before newborn screening introduction, and 5 of them presented with meconium ileus, whereas 44 were identified by newborn screening. Among them 35 needed pancreatic enzyme supplementation, whereas 34 children were infected with P aeruginosa. Both the nonparametric and semiparametric survival estimates failed to show any significant increase in the risk of P aeruginosa infection among screened children compared with historical controls. However, the median time from cystic fibrosis diagnosis to P aeruginosa infection among screened children was significantly shorter (183 vs 448 days). Children with impaired pancreatic function were at high risk of P aeruginosa infection.

CONCLUSIONS. The results of the study suggest that health authorities should regard newborn screening for cystic fibrosis as an opportunity to improve care and outcomes among affected children and shift the focus from whether it is appropriate to screen to how to optimize biomedical and psychosocial outcomes of screening.

---

Key Words: cystic fibrosis • screening • infection

Abbreviations: CF—cystic fibrosis • NBS—newborn screening • RRCCF—Regional Reference Centre for Cystic Fibrosis • IRT—immunoreactive trypsinogen • MI—meconium ileus • HR—hazard ratio • AR-Pa—annual rate of first infection with Pseudomonas aeruginosa • CI—confidence interval

---

Accepted Mar 27, 2006.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				P. D. Sly, S. Brennan, C. Gangell, N. de Klerk, C. Murray, L. Mott, S. M. Stick, P. J. Robinson, C. F. Robertson, S. C. Ranganathan, et al. Lung Disease at Diagnosis in Infants with Cystic Fibrosis Detected by Newborn Screening Am. J. Respir. Crit. Care Med., July 15, 2009; 180(2): 146 - 152. [Abstract] [Full Text] [PDF]