P345 Pulmonary exacerbations in cystic fibrosis

Background in cystic fibrosis (CF), the number of pulmonary exacerbations and their severity determine the lung function decline. Prevention of pulmonary exacerbations and thier early diagnosis slows down the progression of pulmonary disease and of lung function decline, improving both quality of life and life expectancy in CF paediatric patients. Aim the aim of the study was to evaluate predisposable factors associated with pulmonary exacerbations in cystic fibrosis patients at Mother and Child Care Institute „Alessandrescu Rusescu’ between 2013–1016. Method we conducted a four years retrospective study, between 2013–2016 on 68 CF patients. We followed for each patient: the number of exacerbations that required admission, number of admissions per year, time period between exacerbations, lung function, pulmonary infectious status. Results 68 patients were included, with a male predominance (39 boys, 29 girls). Age repartition: 19 patients aged between 1–5 years old, 34 patients aged between 6–11 years old, 15 patients aged between 12–18 years old. 15 patients (22%) had chronic Pseudomonas aeruginosa (PA) infection. 17 patients (25%) were admitted for moderate/severe pulmonary exacerbations, 4 of them having a time period less than 3 months between exacerbations. For these last 4 patients the infectious status was: 2 with PA, 1 with MRSA, 1 with MRSA, PA and Burkholderia caepacia. Lung function decline in admitted patients for pulmonary exacerbations: 16% -more than 15% drop in FEV1, 38% 5%–10% drop in FEV1, the rest of them with a mild drop in FEV 1 (less than 5%). Treatment duration was between 10–21 days with a median of 14 days for 64% of them. Only 2 of these 17 patients had a normal nutritional status. Conclusions predisposable factors for CF pulmonary exacerbations that require admission seem to be: poor nutritional status, incomplete cure of PA first determination, low treatment adherence, polymicrobial pulmonary infections.