Journal article
Differential Geographical Risk of Initial Pseudomonas aeruginosa Acquisition in Young US Children With Cystic Fibrosis
American journal of epidemiology, v 179(12), pp 1503-1513
15 Jun 2014
PMID: 24875373
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Pseudomonas aeruginosa is the sentinel respiratory pathogen in cystic fibrosis patients. We conducted a retrospective study to examine whether state of residence affected risk of P. aeruginosa acquisition among US children under 6 years of age with cystic fibrosis by using data from the Cystic Fibrosis Foundation National Patient Registry, 2003-2009. The outcome was time to first isolation of P. aeruginosa from a respiratory culture. We used a Bayesian hierarchical Weibull regression model with interval-censored outcomes. Spatial random effects, included at the state level and modeled using an intrinsic conditional autoregressive prior, allowed estimation of the residual spatial correlation. The regression portion of the model was adjusted for demographic and disease characteristics potentially affecting P. aeruginosa acquisition. A total of 3,608 children met the inclusion criteria and were followed for an average of 2.1 (standard deviation, 1.6) years. P. aeruginosa was cultured in 1,714 (48%) subjects. There was a moderately elevated spatial residual relative risk. An estimated 95% credible interval for the residual hazard ratio under 1 of the fitted models was 0.64-1.57; the strongest positive association was observed in the Southern states. The fact that risk for P. aeruginosa acquisition displayed spatial dependence suggests that regional factors, such as climate, may play an important role in P. aeruginosa acquisition.
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Details
- Title
- Differential Geographical Risk of Initial Pseudomonas aeruginosa Acquisition in Young US Children With Cystic Fibrosis
- Creators
- Kevin J. Psoter - Johns Hopkins UniversityMargaret Rosenfeld - Seattle Children's HospitalAnneclaire J. De Roos - Drexel UniversityJonathan D. Mayer - University of WashingtonJon Wakefield - University of Washington
- Publication Details
- American journal of epidemiology, v 179(12), pp 1503-1513
- Publisher
- Oxford Univ Press
- Number of pages
- 11
- Grant note
- Cystic Fibrosis Foundation; Italian Cystic Fibrosis Research Foundation Genentech, Inc.; Roche Holding; Genentech
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Environmental and Occupational Health
- Web of Science ID
- WOS:000338106100015
- Scopus ID
- 2-s2.0-84902477603
- Other Identifier
- 991019169800404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health