Scott H. Davis

Barriers to adherence to cystic fibrosis infection control guidelines

In 2003, the American Cystic Fibrosis (CF) Foundation published revised, evidence‐based guidelines for infection control. We sought to assess potential barriers to adherence to these guidelines experienced by health care professionals (HCPs) caring for CF patients.

Prevalence of giardiasis in patients with cystic fibrosis

A group of 107 patients with cystic fibrosis and a control group of 64 normal members of households of patients with cystic fibrosis were surveyed for Giardia lamblia cysts and trophozoites by counterimmunoelectrophoresis of fecal samples. The patient group had a significantly higher rate of infestation than the control group (28.0% vs 6.3%, P = 0.0006), and the disparity between the two groups increased with age (P = 0.005). Aside from cystic fibrosis, all risk factors examined were without influence, except for the presence of household members less than or equal to 5 years of age. We conclude that our patients with cystic fibrosis have a previously unrecognized increased prevalence of giardiasis compared with that in a control population.

Spontaneous subcutaneous emphysema

Subcutaneous emphysema is an unusual complication of bronchiolitis. The investigators describe a patient with bronchiolitis who developed extensive subcutaneous emphysema. Despite an alarming appearance, the patient recovered with symptomatic care and observation. Review of the literature shows a multitude of causes of subcutaneous emphysema. The vast majority of cases resolve without intervention.

1750 SWEAT POTASSIUM (K + ) VALUES IN CHILDREN WITH CYSTIC FIBROSIS (CF)

We retrospectively studied the results of sweat K+ values gathered on initial presentation from patients with CF to determine whether sweat K+ values varied with age. Two hundred seventy four sweat collections were obtained by the Gibson-Cooke method from 204 patients with CF over a ten year+period and were analyzed for sodium (Na+), Chloride (Cl), and K+ by the same technician. We excluded tests performed on patients already diagnosed and under treatment for CF, leaving a total of 112 patients. In the case of duplicate sweat tests on the same person, the test with the largest amount of sweat was used for analysis. The mean sweat Na+, Cl−, and K+ for patients <1 year and >1 year are compared in the table.The findings of lower sweat Na+ and higher sweat K+ in infants compared to older children may reflect hyperaldosteronism secondary to inadequate salt replacement prior to diagnosis. Loss of large quantities of K+ in the sweat in infants with CF may predispose them to hypokalemia and metabolic alkalosis.