266 ‘Arresting’ psychological issues for better health outcomes in parents of infants and young children with cystic fibrosis C.A. Branch-Smith1, J.A. Pooley2, L. Shields3, S. Stick1,4, T. Douglas4,5, on behalf of AREST CF. 1Telethon Institute for Child Health Research, Clinical Sciences, Perth, Australia; 2Edith Cowan University, School of Psychology and Social Science, Perth, Australia; 3James Cook University, School of Nursing, Midwifery and Nutrition, Townsville, Australia; 4University of Western Australia, School of Paediatric and Child Health, Perth, Australia; 5Curtin University, School of Psychology, Perth, Australia

WS2.1 “Feeling my way”: Information needs for parents whose child has been diagnosed with CF following newborn screening M. Jessup1, L. Shields2, S. Grogan3, C.A. Branch-Smith3, T.A. Douglas, on behalf of AREST CF4. 1Australian Catholic University/The Prince Charles Hospital, Research Centre, Brisbane, Australia; 2James Cook University/Townsville Hospital and Health District, Tropical Health Research Unit, Townsville, Australia; 3Telethon Institute for Child Health Research, Perth, Australia; 4Curtin University/ Princess Margaret Hospital for Children, Perth, Australia

When do infants and young children with cystic fibrosis acquire infection with Pseudomonas aeruginosa? Can this be eradicated when first detected?Children <6 yrs of age participated in an annual bronchoalveolar lavage (BAL)-based microbiological surveillance programme in Perth, Australia. When P. aeruginosa was detected, an eradication programme using combination treatment with i.v., oral and nebulised antibiotics was undertaken. Repeat BAL was performed 3 months following treatment, to assess eradication success.P. aeruginosa was detected in 33 (28.4%) children; median (range) age at detection was 30.5 (3.3-71.4) months. P. aeruginosa was mucoid at detection in six (18.2%) out of 33 patients and associated with respiratory symptoms in 16 (48.5%) out of 33 children. In total, 26 children underwent eradication therapy, with P. aeruginosa eradicated in 20 (77%) out of 26 following one eradication cycle and in three (total 88%) additional children following a second cycle.Eradication was associated with a significant decrease in neutrophil elastase and interleukin-1 beta in BAL fluid 12 months post eradication. Eradication of Pseudomonas aeruginosa infection is achievable in young children with cystic fibrosis for up to 5 yrs using combination i.v., oral and nebulised antibiotic therapy and is associated with reduced pulmonary inflammation 12 months post eradication.

BACKGROUND:The relationship between atopy and bronchial allergy in young children is not completely understood.OBJECTIVE:To examine the association between response to bronchial allergen challenge, immune markers of atopy and other clinical characteristics in 5- to 6-year-old children.METHODS:Children with positive skin test (SPT) to aeroallergen, together with a proportion of SPT negative children (as controls), were recruited from a birth cohort of 198 children at high risk of developing atopic disease and underwent allergen challenge.RESULTS:Thirty-seven children (26 atopic and 11 SPT negative), median age 74.5 months, were challenged: 31 with house dust mite and six with grass allergen. Only atopic children responded to challenge: n = 12/26 (46%). Wheal size [odds ratio (OR) 2.5 (1.2-5.3), P = 0.01], allergen-specific immunoglobulin E (IgE) [OR 3.4 (1.23-9.61), P = 0.02], total IgE [OR 8.6 (1.1-68.7), P = 0.04], current wheeze [OR 12 (1.7-81.7), P = 0.006] and persistent eczema [OR 11.0 (1.7-68.3), P = 0.006] emerged as the strongest independent predictors of response to allergen challenge. Prediction of response to allergen challenge was significantly improved when immune markers of atopy, and in particular wheal size, were combined with clinical characteristics.CONCLUSION:The relationship between atopy and bronchial allergy is quantitative at this age. There may be potential to create more powerful indicators of the presence of respiratory allergy in young children when immunological markers of atopy are considered quantitatively and when combined with clinical history of coexistent allergic disease.