THE IMPACT OF RESPIRATORY TRACT INFECTIONS ON THE NUTRITIONAL STATE OF CHILDREN WITH CYSTIC FIBROSIS

Cystic fibrosis (CF) is a life-shortening, autosomal-recessive disorder characterized by intestinal malabsorption, impaired growth and lung disease. Recurrent pulmonary infections in children with CF are often associated with nutritional deficiencies. Aim: To emphasize the effects of recurrent pulmonary infections on nutritional status in children with CF. Material and methods: This retrospective study included 27 patients diagnosed with CF between 1994 and 2011 in the 3rd Pediatric Clinic of the Iasi "Saint Mary" Children’s Hospital. The nutritional status was assessed according to ponderal index (PI), body mass index (BMI), Z score for weight and waist. Correlations between the age of onset of symptoms, age at diagnosis, and frequency of infectious episodes, identified bacterial agents and nutritional status were established. Results: Patients aged between 3 months old and 17 years old with an average of 49.48 months ± 9.83DS; sex ratio was 1.7:1. The patients were diagnosed late, one month to 112 months (average 41.11 months±9.4DS) from the first symptoms until the moment of diagnosis. The clinical forms of CF in the study group were: predominantly respiratory manifestations in 48.14% of cases, and the mixed type, with both respiratory and digestive symptoms, in 18.52% of cases. Delayed weight and/or height gains were identified in 85.19% of cases. The etiologic agents involved in pulmonary infections were Staphylococus aureus (48.14%), Pseudomonas aeruginosa (33.33%), Stenotrophomonas maltophilia (18.51%), Haemophilus influenzae (14.8%), Klebsiella pneumoniae (11.10%), Moraxella catarrhalis (7,40%), Streptococcus pneumoniae (7.40%), Neisseria sica (7.40%). Pulmonary infections caused by Staphylococus aureus, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia were more often associated with nutritional status abnormalities. Conclusions: In small children with CF pulmonary infections due to various causative agents cause a slow rate of growth (both weight and height). Good nutrition and adequate early treatment of pulmonary infections are beneficial for the general state of affected children and are very important in maintaining their health.