13 July 2011 MEDIA RELEASE Groundbreaking Cystic Fibrosis study has international implications A groundbreaking study by a Brisbane researcher

will lead to dramatic changes in the way severe lung infections are managed in hospital for babies and young children with Cystic Fibrosis (CF). The 10 year study is a world first and will have major implications in both Australia and internationally as it will lessen the number of anaesthetics and tests needed for these sick young patients. The study is being published today in the prestigious Journal of the American Medical Association. QCMRI Professor Claire Wainwright studied 157 infants with CF. She found that health outcomes by five years of age in those simply having a swab taken from the back of the throat whenever they became ill were no different from children undergoing a test in hospital using a bronchoscope (a flexible tube with a camera passed through the mouth or nose into the lungs while under general anaesthetic) to obtain respiratory secretions (phlegm) from deep within the lungs. The implications of this study will mean not only far less anxiety for children and their parents, it will also be far less costly because there will be fewer procedures performed requiring a general anaesthetic, Professor Wainwright said. We compared a group of children having a bronchoalveolar lavage or BAL (procedure using a bronchoscope) with a group only having regular swabs at the time of a suspected severe respiratory infection and we found that both tests provided similar information and outcomes. The study found there was no added benefit in doing the BAL routinely whenever a child with CF fell ill and had worsening cough or breathing difficulties requiring admission to hospital. In fact in around a third of study participants who had the BAL there were some mild adverse effects such as a fever within 24 hours of the procedure or their cough became worse for a few hours. While there will still be a need to use a bronchoscope to diagnose chronic or rare infections, especially if the child is not responding to treatment, bronchoscopy will no longer be required routinely when children with CF are admitted to hospital because of a severe lung infection. BAL is a safe procedure that has been used for around twenty years and mostly is well tolerated. The use of BALs has become increasingly common here and internationally to detect infection in the lungs in young children. Its a key thing when dealing with young children to find infection early and to get rid of it quickly to prevent long term lung damage, which is why BAL procedures were becoming more and more common world-wide because there are concerns that the throat swabs do not always accurately reflect infection in the lung. Currently there are around 500 CF patients under the age of six in Australia who would most likely undergo this type of procedure. This study shows it is just as important to test procedures as it is to test drugs. There are some small risks with a general anaesthetic and you dont do it without good reason. For young children youd want to avoid it if you could. QCMRI Director Professor Keith Grimwood said the results of Professor Wainwrights study had been eagerly awaited by the CF community world-wide and would have far reaching implications.

BAL is a safe technique but the procedure is invasive and its good news it no longer needs to always happen routinely when infants and young children are admitted to hospital with a serious respiratory infection, Professor Grimwood said. These results will be welcomed not only by families of children with CF but also by their health carers. Were delighted Professor Wainwright has been able to make such a significant contribution to the way CF infections will be monitored in the future. Nevertheless, it is important to emphasise that bronchoscopy remains an important investigative research tool in CF as well as having an essential role when treatment is failing. The landmark study will lead to a number of human and economic spin-off studies, including measuring anxiety levels of patients with CF undergoing invasive procedures and the financial cost to the health system. Claire Wainwright, a research leader with the Queensland Childrens Medical Research Institute (QCMRI) and Professor of Paediatrics at the University of Queensland, conducted the study whilst employed at the Royal Childrens Hospital. Organisations including the Royal Childrens Hospital Foundation (RCHF) and the National Health and Medical Research Council (NHMRC) played a major role in funding the study over the 10 year period. Media Contacts: Sequel Communications Kathryn Stevens 07 4162 1021 or 0403 090 912 or Melissa Nelson on 07 3251 8139 or 0434 313 064