Exploring Antimicrobial Resistance and Genetic Profile as Mortality and Morbidity Indicators in Pediatric Cystic Fibrosis

Cystic Fibrosis is a multisystem disease that follows an autosomal recessive inheritance pattern. Pulmonary involvement is the most common cause of morbidity in these patients. In this study, we investigate the impact of antimicrobial resistance and genetic profile through a retrospective cohort study in 176 children from 2017-2021 in Western Romania. As treatment for Cystic Fibrosis infections is usually with the same group of antibiotics, we aimed to study antibiotic resistance as a whole. We observed that aminoglycoside resistance is associated with 35% respiratory exacerbations. Out of the 43 patients with aminoglycoside resistance, 15 experienced respiratory exacerbations. Although penicillin resistance is associated with increased mortality, in our study, we found that mortality was lower in the penicillin resistant cohort (38%) when compared to the penicillin non resistant cohort (54%). Out of 115 patients that exhibited penicillin resistance, 44 died and out of 61 patients that did not exhibit penicillin resistance, 33 died. On genetic profiling, we found that the DF508/N1303K subtype was protective while the DF508/C524X subtype was associated with increased mortality. More studies are needed to understand if they can be used as indicators of mortality and morbidity in pediatric cystic fibrosis outcomes. Conflicts of InterestThe authors declare that there are no conflicts of interest regarding the publication of this manuscript.