Chronic<i>Pseudomonas aeruginosa</i>Infection in Chronic Obstructive Pulmonary Disease

Martínez-Solano, Laura; Macià, María D.; Fajardo, Alicia; Oliver, Antonio; Martínez, José Luis

doi:10.1086/593186

Cited by 234 publications

(195 citation statements)

References 38 publications

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“…Decreased sIgA levels lead to immunocompromisation and result in critical LRT infections that prompt the use of broadspectrum antibiotics, which in turn bolsters fungal emergence in the airways (34). Pseudomonas aeruginosa (P. aeruginosa), a Gram-negative non-fermenting bacterium found in bronchiectasis patients with severely affected pulmonary function (e.g., requiring mechanical ventilation), is known for its mutational and biofilm producing abilities, conferring it resistance to antibiotics (35). As A. fumigatus is known to grow as a biofilm in vivo, the possibility of an interaction between these two species has been suggested, with P. aeruginosa providing biofilm niches that allow the expansion of invasive fungal colonies (36).…”

Section: Discussionmentioning

confidence: 99%

Immunity status of invasive pulmonary aspergillosis patients with structural lung diseases in Chinese adults

Liang

Jiang

et al. 2017

J. Thorac. Dis.

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Background: Invasive pulmonary aspergillosis (IPA) is a fungal infection frequently observed in patients with immune dysfunction, such as those suffering from structural lung diseases. Nevertheless, studies assessing IPA combined with other common respiratory diseases remain scarce, particularly those regarding the immune status of its patients. Different structural lung diseases are known to differently affect patient immune status; however, the mechanisms by which this is conferred have yet to be determined. Thus, our study aims to compare the immune status of IPA patients with the structural lung diseases chronic obstructive pulmonary diseases (COPD), interstitial lung disease (ILD) and non-cystic fibrosis bronchiectasis (NCFB). IPA is well-recognized as a severe fungal lung infection, frequently observed in patients following procedures such as allogeneic bone marrow transplantation and solid organ transplantation, as well as alongside conditions including hematologic malignancies, late-stage HIV infection, and chronic granulomatosis (1-3). The disease has also grown in prevalence as a comorbidity in patients with structural lung diseases such as chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and noncystic fibrosis bronchiectasis (NCFB)-all of which confer different immune dysfunctions to their patients.Due to the significance of immunology in fungal infection, IPA has been an area of focus for many experts. Several studies have described an increase of IPA incidence in COPD patients (3-7); however, IPA assessments in relation to other common respiratory diseases remain scarce, particularly those evaluating patient immune status. Therefore, this study aims to assess the immune status of IPA patients with COPD, ILD, and NCFB while excluding the presence of basic diseases. Methods Study design and diagnostic procedureOur study retrospectively assessed patients treated at Shanghai Pulmonary Hospital, Tongji University, between 2004 and 2013. Diagnosis of IPA was classified as proven, probable, or possible in accordance with the revised EORTC and MSG criteria (8,9). Consequently, a diagnosis of "proven IPA" was established by both (I) the presence of hyphae compatible with Aspergillus in specimens collected from a pulmonary lesion sample; and (II) isolation of Aspergillus species in cultures from any lower respiratory tract (LRT) sample, mainly sputum and bronchial secretions, including bronchial brush and bronchial alveolar lavage fluid, etc. combined with evidence of associated tissue damage or two sequential positive serum galactomannan (GM) tests.COPD diagnosis was established according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria (10). In patients with COPD, Bulpa criteria were used for IPA diagnosis (5). NCFB diagnosed routinely and confirmed through high-resolution computed tomography (HRCT) chest imaging and patient history of the syndrome (11,12). ILD diagnosis was established according to the American Thoracic Society Clinical Practice Gu...

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Section: Discussionmentioning

confidence: 99%

Immunity status of invasive pulmonary aspergillosis patients with structural lung diseases in Chinese adults

Liang

Jiang

et al. 2017

J. Thorac. Dis.

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“…DRPM has wide-spectrum antibacterial activity against gram-positive and gram-negative bacteria, and is particularly effective against P. aeruginosa in vitro when compared with other carbapenems, such as MEPM. P. aeruginosa is now being recognized as a relevant pathogen in chronic obstructive pulmonary disease (COPD) [11]. In COPD, after a clone is established, it remains in the lung for long periods, and can develop increasing degrees of antibiotic resistance and strong diversification [11].…”

Section: Discussionmentioning

confidence: 99%

“…P. aeruginosa is now being recognized as a relevant pathogen in chronic obstructive pulmonary disease (COPD) [11]. In COPD, after a clone is established, it remains in the lung for long periods, and can develop increasing degrees of antibiotic resistance and strong diversification [11].…”

Section: Discussionmentioning

confidence: 99%

In vivo efficacy of doripenem (DRPM) against Pseudomonas aeruginosa in murine chronic respiratory tract infection model

Araki

Yamada

Kamihira

et al. 2011

Journal of Infection and Chemotherapy

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Doripenem is a carbapenem antibiotic with broad-spectrum coverage of gram-positive and gram-negative bacteria, including Pseudomonas aeruginosa, and is considered to be as effective as meropenem. The in vivo activity of doripenem was thus compared with that of meropenem in a chronic lower respiratory P. aeruginosa infection mouse model. The number of viable bacteria in the lungs after treatment with doripenem, meropenem, and saline mice was 2.01 ± 0.69, 2.03 ± 0.48 and 3.90 ± 1.40 log 10 CFU/lung, respectively. The number of viable bacteria in the lungs of mice treated with doripenem and meropenem was significantly lower than that in lungs of controls.Histopathological examination of lung specimens from the control group revealed promotion of the inflammatory response in chronic bronchial infection. However, the groups treated with doripenem and meropenem showed weaker inflammatory responses. These results suggest that doripenem treatment is effective against chronic airway infection with P. aeruginosa.

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“…Bacteria have been found to be the cause of acute exacerbation in 50-80% of COPD patients, predominately due to Streptococcus pneumonia, Haemophilus influenza and Moraxella catarrhalis, as well as other Gram-negative organisms such as Pseudomonas and Enterobacteriaceae spp [61,62]. P. aeruginosa is being investigated as a causative pathogen for exacerbations in severe COPD cases [63]. It has been isolated from 4-15% of adults with severe COPD requiring mechanical ventilation.…”

Section: Pseudomonas Aeruginosa and Chronic Obstructive Pulmonary Dismentioning

confidence: 99%

“…It has been isolated from 4-15% of adults with severe COPD requiring mechanical ventilation. COPD has been associated with increased bacterial mutation rates, increased resistance to antibiotics and greater biofilm production which is comparable to CF even though these two disease have completely different pathogenesis [63].…”

Section: Pseudomonas Aeruginosa and Chronic Obstructive Pulmonary Dismentioning

confidence: 99%

A New Era of Pulmonary Delivery of Nano-antimicrobial Therapeutics to Treat Chronic Pulmonary Infections

Merchant

Buckton²,

Taylor³

et al. 2016

CPD

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Pulmonary infections may be fatal especially in immunocompromised patients and patients with underlying pulmonary dysfunction, such as those with cystic fibrosis, chronic obstructive pulmonary disorder, etc. According to the WHO, lower respiratory tract infections ranked first amongst the leading causes of death in 2012, and tuberculosis was included in the top 10 causes of death in low income countries, placing a considerable strain on their economies and healthcare systems. Eradication of lower respiratory infections is arduous, leading to high healthcare costs and requiring higher doses of antibiotics to reach optimal concentrations at the site of pulmonary infection for protracted periods. Hence direct inhalation to the respiratory epithelium has been investigated extensively in the past decade, and seems to be an attractive approach to eradicate and hence overcome this widespread problem. Moreover, engineering inhalation formulations wherein the antibiotics are encapsulated within nanoscale carriers could serve to overcome many of the limitations faced by conventional antibiotics, like difficulty in treating intracellular pathogens such as mycobacteria spp. and salmonella spp., biofilmassociated pathogens like Pseudomonas aeruginosa and Staphylococcus aureus, passage through the sputum associated with disorders like cystic fibrosis and chronic obstructive pulmonary disorder, systemic side effects following oral/parenteral delivery and inadequate concentrations of antibiotic at the site of infection leading to resistance. Encapsulation of antibiotics in nanocarriers may help in providing a protective environment to combat antibiotic degradation, confer controlled-release properties, hence reducing dosing frequency, and may increase uptake via specific and non-specific targeting modalities. Hence nanotechnology combined with direct administration to the airways using commercially available delivery devices, is a highly attractive formulation strategy to eradicate microorganisms from the lower respiratory tract, which might otherwise present opportunities for multi-drug resistance.

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ChronicPseudomonas aeruginosaInfection in Chronic Obstructive Pulmonary Disease

Cited by 234 publications

References 38 publications

Immunity status of invasive pulmonary aspergillosis patients with structural lung diseases in Chinese adults

Immunity status of invasive pulmonary aspergillosis patients with structural lung diseases in Chinese adults

In vivo efficacy of doripenem (DRPM) against Pseudomonas aeruginosa in murine chronic respiratory tract infection model

A New Era of Pulmonary Delivery of Nano-antimicrobial Therapeutics to Treat Chronic Pulmonary Infections

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