Changing epidemiology of the respiratory bacteriology of patients with cystic fibrosis–data from the European cystic fibrosis society patient registry

Hatziagorou, Elpis; Orenti, Annalisa; Dřevı́nek, Pavel; Kashirskaya, N.; Mei-Zahav, Meir; Boeck, K. De; Pfleger, Andreas; Sciensano, Muriel Thomas; Lammertyn, Elise; Maçek, Milan; Olesen, Hanne Vebert; Farge, Anne; Naehrlich, L.; Újhelyi, Rita; Fletcher, G.; Padoan, Rita; Timpare, Zane; Malakauskas, Kęstutis; Fustik, S.; Gulmans, Vincent; Turcu, O.; Pereira, Luí­sa Álvares; Mosescu, S.; Rodić, Milan; Kayserová, H.; Krivec, Uroš; Vázquez-Cordero, Carlos; Monestrol, Isabelle de; Lindblad, Anders; Jung, Anna; Makukh, Halyna; Carr, Siobhán; Cosgriff, Rebecca; Zolin, A.

doi:10.1016/j.jcf.2019.08.006

Cited by 66 publications

(43 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Carriage of S. maltophilia is quite common in patients with CF and has been increasing in prevalence since the mid-1990s (9,33). S. maltophilia is widely distributed in a range of environmental sites, including water and soil.…”

Section: Discussionmentioning

confidence: 99%

Cooperativity between Stenotrophomonas maltophilia and Pseudomonas aeruginosa during Polymicrobial Airway Infections

2020

View full text Add to dashboard Cite

Stenotrophomonas maltophilia is a Gram-negative bacterium found ubiquitously in the environment that has historically been regarded as nonpathogenic. S. maltophilia is increasingly observed in patient sputa in cystic fibrosis (CF), and while existing epidemiology indicates that patients with S. maltophilia have poorer diagnoses, its clinical significance remains unclear. Moreover, as multidrug resistance is common among S. maltophilia isolates, treatment options for these infections may be limited. Here, we investigated the pathogenicity of S. maltophilia alone and during polymicrobial infection with Pseudomonas aeruginosa. Colonization, persistence, and virulence of S. maltophilia were assessed in experimental respiratory infections of mice. The results of this study indicate that S. maltophilia transiently colonizes the lung accompanied by significant weight loss and immune cell infiltration and the expression of early inflammatory markers, including interleukin 6 (IL-6), IL-1α, and tumor necrosis factor alpha (TNF-α). Importantly, polymicrobial infection with P. aeruginosa elicited significantly higher S. maltophilia counts in bronchoalveolar lavages and lung tissue homogenates. This increase in bacterial load was directly correlated with the density of the P. aeruginosa population and required viable P. aeruginosa bacteria. Microscopic analysis of biofilms formed in vitro revealed that S. maltophilia formed well-integrated biofilms with P. aeruginosa, and these organisms colocalize in the lung during dual-species infection. Based on these results, we conclude that active cellular processes by P. aeruginosa afford a significant benefit to S. maltophilia during polymicrobial infections. Furthermore, these results indicate that S. maltophilia may have clinical significance in respiratory infections.

show abstract

Section: Discussionmentioning

confidence: 99%

Cooperativity between Stenotrophomonas maltophilia and Pseudomonas aeruginosa during Polymicrobial Airway Infections

2020

View full text Add to dashboard Cite

show abstract

“…Our studies found that the most common infectious pathogens in CF patients in China were P. aeruginosa (64.5%), followed by S. aureus (14.0%). Studies have reported the changing prevalence of infections caused by different CF‐associated pathogens according to data from both the North American Cystic Fibrosis Foundation Patient Registry (CFFPR) 60 and the European Registry 61 . The pathogens with the highest prevalence and incidence in 2012 in America were methicillin‐sensitive S. aureus (MSSA) and P. aeruginosa , followed by MRSA, while in 2016 in Europe, the pathogens with the highest prevalence were S. aureus and P. aeruginosa , accounting for 38.3% and 29.8% of cases, respectively.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the clinical and genetic characteristics of Chinese patients with cystic fibrosis

Shi

Wang

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

Objectives: To investigate and summarize the clinical and genetic characteristics of Chinese cystic fibrosis (CF) patients to improve clinicians' understanding and decrease the rates of misdiagnosis and missed diagnoses in China. Methods: The EMBASE, Cochrane Library, PubMed and SinoMed databases were searched for studies involving Chinese CF patients from January 1975 to August 2019. Results: In total, 113 Chinese patients, including 53 males and 60 females, were reported. Nineteen patients had a family history of CF. The median age at diagnosis was 8.7 years. Among Chinese CF patients, 70.8% had bronchiectasis, 9.7% had a hemoptysis history, 33.6% had clubbed fingers, 17.7% had allergic bronchopulmonary aspergillosis, and 29.2% had chronic diarrhea; the incidence of malnutrition was 52.2%. Five patients had jaundice, 26 patients had hepatomegaly, and 9 patients had meconium ileus in the neonatal period, and the incidence of liver cirrhosis was 5.3%. The predominant organism in airways was Pseudomonas aeruginosa, followed by Staphylococcus aureus. Seventy-nine patients underwent the sweat test, and all of them were positive, with an average chloride ion level of 122.2 mmol/L. Eighty-eight Chinese CF patients underwent genetic testing, and 74 CF transmembrane conductance regulator (CFTR) gene mutations were reported. The most common gene mutation was c.2909G→A. One Phe508del gene mutation was observed. Conclusion: The common clinical manifestations and CFTR gene mutations in Chinese CF patients are different from those in Caucasian patients. The age at CF diagnosis in China is relatively old, suggesting that the CF incidence in China may be seriously underestimated.

show abstract

“…Although S. maltophilia are thought to be low-grade pathogens and a rather uncommon cause of bacterial disease in humans, they are increasingly recognized as significant opportunistic pathogens in healthcare settings worldwide, being one of the ten most common organisms found in respiratory tissue samples taken from intensive care unit (ICU) patients in Europe (Zuschneid et al, 2007;Gherardi et al, 2015). Several nosocomial outbreaks of S. maltophilia infection and/or colonization have been reported (Denton and Kerr, 1998), and the global prevalence and incidence of these bacteria as human pathogens have increased significantly during the last decade (Chang et al, 2015;Nayyar et al, 2017;Rutter et al, 2017), particularly in cystic fibrosis patients (Hatziagorou et al, 2019). The most common clinical manifestations of S. maltophilia infections include pneumonia, bacteremia, wound or urinary-tract infections (Looney et al, 2009;Gales et al, 2019), with crude mortality rates ranging from 14 to 69% in patients with bacteremia, being highest among patients receiving inappropriate initial antimicrobial therapy (Paez and Costa, 2008;Falagas et al, 2009;Kim et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Genetic Variants of the DSF Quorum Sensing System in Stenotrophomonas maltophilia Influence Virulence and Resistance Phenotypes Among Genotypically Diverse Clinical Isolates

et al. 2020

View full text Add to dashboard Cite

The pathogenicity of Stenotrophomonas maltophilia is regulated in part by its quorum sensing (QS) system. The main QS signaling molecule in S. maltophilia is known as diffusible signal factor (DSF), and the rpf gene cluster is responsible for its synthesis and perception. Two cluster variants have been previously described, rpf-1 and rpf-2, which differ basically in the conditions under which DSF is produced. Here, correlations between the rpf variant and antibiotic susceptibility, LPS electrophoretic profiles and virulence-related phenotypes were evaluated for a collection of 78 geographically and genetically diverse clinical strains of S. maltophilia. In general there were associations between previously established genogroups and the genetic variant of the rpf cluster. However, only few genotype-phenotype correlations could be observed. Resistance to the β-lactam antibiotics ceftazidime and ticarcillin was associated with strains carrying the rpf-1 variant, whereas strains of variant rpf-2, particularly those of genogroup C, showed higher resistance levels to colistin. Strains of variant rpf-2 were also significantly more virulent to Galleria mellonella larvae than those of rpf-1, most likely due to an increased ability of rpf-2 strains to form biofilms. A comparative genomic analysis revealed the presence of proteins unique to individual genogroups. In particular, the strains of genogroup C share an operon that encodes for a new virulence determinant in S. maltophilia related to the synthesis of an alternative Flp/Tad pilus. Overall, this study establishes a link between the DSF-based QS system and the virulence and resistance phenotypes in this species, and identifies potential high-risk clones circulating in European hospitals.

show abstract

Changing epidemiology of the respiratory bacteriology of patients with cystic fibrosis–data from the European cystic fibrosis society patient registry

Cited by 66 publications

References 39 publications

Cooperativity between Stenotrophomonas maltophilia and Pseudomonas aeruginosa during Polymicrobial Airway Infections

Cooperativity between Stenotrophomonas maltophilia and Pseudomonas aeruginosa during Polymicrobial Airway Infections

A systematic review of the clinical and genetic characteristics of Chinese patients with cystic fibrosis

Genetic Variants of the DSF Quorum Sensing System in Stenotrophomonas maltophilia Influence Virulence and Resistance Phenotypes Among Genotypically Diverse Clinical Isolates

Contact Info

Product

Resources

About