Clinical outcomes for cystic fibrosis patients with Pseudomonas aeruginosa cross‐infections

Abstract

IntroductionPseudomonas aeruginosa cross‐infections are related to increased morbidity and mortality in cystic fibrosis (CF).ObjectivesThe aim of the study was to evaluate the incidence of cross‐infections with P. aeruginosa in children with CF.MethodologyCF patients from whom at least one P. aeruginosa strain had been isolated were included in the study. The strain genotyping was performed using pulse‐field gel electrophoresis. The history of contacts between patients was established based on questionnaires.ResultsThe study group consisted of 75 patients (aged 1.0‐19.2 years) and the material included 170 P. aeruginosa strains. Cross‐infections occurred in a group of 26 patients. In this group, the risk of the predicted occurrence of forced expiratory volume in 1 second ≤ 70% was five times greater and the risk of longer cumulative hospitalization time for intravenous antibiotic therapy (>14 days/year) was almost five times greater. In the clonal groups of strains, the multidrug‐resistance rate was significantly higher than in other groups. In 2011, all tested strains were susceptible to colistin, whereas in 2012, three strains from the largest clonal group showed high levels of resistance to colistin.ConclusionCross‐infections with P. aeruginosa occurred in our group of patients and were associated with poor clinical outcomes. Antimicrobial resistance rate in the strains isolated from such infections was significantly higher, and this included three strains resistant to colistin.

Cystic fibrosis year in review 2019: Section 2 pulmonary disease and infections

“…from 10 CF centers identified a circulating multiresistant clone of Achromobacter xylosoxidans ( formerly called Alcaligenes xylosoxidans) in 7 patients from 5 centers; it was similar to a Danish epidemic strain. Another study of from Poland included 75 children with CF who had 170 PA strains 34 . The 26 children who had clonal strains of PA had more multidrug resistant strains, a five times greater risk of having FEV1pp < 40 percent predicted, and a greater risk of cumulative hospitalization time for IV antibiotics greater than 14 days.…”

Antimicrobial effects of Melaleuca alternifolia (tea tree) essential oil against biofilm-forming multidrug-resistant cystic fibrosis-associated Pseudomonas aeruginosa as a single agent and in combination with commonly nebulized antibiotics

“…2001; Milczewska et al . 2020). It is, therefore, essential that the features of CFPA that contribute to persistent infection, and antimicrobial susceptibility profiles are understood, so that therapies can be developed and optimized.…”

“…The most commonly isolated bacteria are Staphylococcus aureus and Pseudomonas aeruginosa, the former being more prevalent in children and the latter being almost ubiquitous in adults (Bell et al 2011). Infection with CF-associated P. aeruginosa (CFPA) is frequently associated with negative clinical outcomes (Nixon et al 2001;Milczewska et al 2020). It is, therefore, essential that the features of CFPA that contribute to persistent infection, and antimicrobial susceptibility profiles are understood, so that therapies can be developed and optimized.…”

Activity of newest generation β-lactam/β-lactamase inhibitor combination therapies against multidrug resistant Pseudomonas aeruginosa

“…Pseudomonas aeruginosa is responsible for the majority of bacterial lung infections in the adult CF population; in 2019 77.6% of Australian CF patients older than 25 years had P. aeruginosa present in their respiratory tract 2 . Colonisation and infection with CF-associated P. aeruginosa (CFPA) are significant events in the clinical course of the CF, and are associated with increased morbidity and mortality 3 .…”