Understanding Pseudomonas status among adults with cystic fibrosis: a real-world comparison of the Leeds criteria against clinicians’ decision

• DOI: 10.1007/s10096-017-3168-4
• Publication Date: 2018-01-06T04:00:23Z
• Authors: Zhe Hui Hoo; Frank Peter Edenb...; Rachael Curley; Laura Prtak; Jane Dewar; Mark Ivan Allenby; Julia Anne Nighti...; Martin James Wildman
• Keywords: Medical microbiology

Pseudomonas aeruginosa status influences cystic fibrosis (CF) clinical management but no 'gold standard' definition exists. The Leeds criteria are commonly used may lack sensitivity for chronic P. aeruginosa. We compared clinicians' decision with the in three adult CF centres. Two independent prospective datasets (Sheffield dataset, n = 185 adults; ACtiF pilot 62 adults from two different centres) were analysed. Clinicians involved deciding blinded to study objectives. considered more have infection criteria. This was so Sheffield dataset (106/185, 57.3% vs. 80/185, 43.2% criteria; kappa coefficient between these methods 0.72) (34/62, 54.8% 30/62, 48.4% 0.82). However, clinicians across centres relatively consistent once age and severity of lung disease, as indicated by type respiratory samples provided, taken into account. Agreement similar both among who predominantly provided sputum (kappa 0.78) or > 25 years old Across centres, did not always agree tended consider sensitivity. Where disagreement occurred, diagnose because other relevant information considered. These results suggest that a better might be developed using consensus move beyond wholly dependent on standard microbiological results.