Colonization of the Respiratory Tract with Pseudomonas cepacia in Cystic Fibrosis

Tablan, Ofelia C.; Martone, William J.; Doershuk, Carl F.; Stern, Robert C.; Thomassen, Mary Jane; Klinger, Jeffrey D.; White, Jennifer A.; Carson, Loretta A.; Jarvis, William R.

doi:10.1378/chest.91.4.527

Cited by 165 publications

(107 citation statements)

References 6 publications

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“…The CF community, the Centers for Disease Control and Prevention, and the American Society for Microbiology en- dorse the use of selective media for processing respiratory tract specimens from patients with CF (11,15,28). However, there has not been a consensus for the use of selective media other than those for B. cepacia complex, e.g., OFPBL agar or B. cepacia selective medium (13).…”

Section: Most (89%) Isolates From Cf Patients Identified Asmentioning

confidence: 99%

Identification and Antimicrobial Susceptibility of Alcaligenes xylosoxidans Isolated from Patients with Cystic Fibrosis

et al. 2001

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In the past decade, potential pathogens, including Alcaligenes species, have been increasingly recovered from cystic fibrosis (CF) patients. Accurate identification of multiply antibiotic-resistant gram-negative bacilli is critical to understanding the epidemiology and clinical implications of emerging pathogens in CF. We examined the frequency of correct identification of Alcaligenes spp. by microbiology laboratories affiliated with American CF patient care centers. Selective media, an exotoxin A probe for Pseudomonas aeruginosa, and a commercial identification assay, API 20 NE, were used for identification. The activity of antimicrobial agents against these clinical isolates was determined. A total of 106 strains from 78 patients from 49 CF centers in 22 states were studied. Most (89%) were correctly identified by the referring laboratories as Alcaligenes xylosoxidans. However, 12 (11%) strains were misidentified; these were found to be P. aeruginosa (n ‫؍‬ 10), Stenotrophomonas maltophilia (n ‫؍‬ 1), and Burkholderia cepacia (n ‫؍‬ 1). Minocycline, imipenem, meropenem, piperacillin, and piperacillin-tazobactam were the most active since 51, 59, 51, 50, and 55% of strains, respectively, were inhibited. High concentrations of colistin (100 and 200 g/ml) inhibited 92% of strains. Chloramphenicol paired with minocycline and ciprofloxacin paired with either imipenem or meropenem were the most active combinations and inhibited 40 and 32%, respectively, of strains. Selective media and biochemical identification proved to be useful strategies for distinguishing A. xylosoxidans from other CF pathogens. Standards for processing CF specimens should be developed, and the optimal method for antimicrobial susceptibility testing of A. xylosoxidans should be determined.Cystic fibrosis (CF) is the most common life-shortening disease caused by a recessive autosomal gene in the Caucasian population and afflicts about 60,000 patients worldwide, approximately 30,000 of whom are cared for in the United States (21). While the genetic defect in CF is known, the relationship between abnormal CF transmembrane conductance regulator and chronic pulmonary disease is not yet fully understood (22). Chronic pulmonary disease is characterized by a vicious cycle of inflammation and infection and is the major cause of morbidity and mortality. The pathogens of CF are well characterized and include Staphylococcus aureus, nontypeable Haemophilus influenzae, Pseudomonas aeruginosa, and Burkholderia cepacia (10).During the past decade, several additional potential pathogens have been recovered from CF patients, including nontuberculous mycobacteria (19), Stenotrophomonas maltophilia (3), and Alcaligenes species, particularly Alcaligenes xylosoxidans (29). As reported to the U.S. Cystic Fibrosis Foundation's National Patient Registry in 1996 and 1997, 1.9 and 2.7% of all CF patients harbored Alcaligenes spp. (7,8). As determined by a research laboratory participating in a phase III trial of aerosolized tobramycin in CF patients who were Ն6 years of ...

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Section: Most (89%) Isolates From Cf Patients Identified Asmentioning

confidence: 99%

Identification and Antimicrobial Susceptibility of Alcaligenes xylosoxidans Isolated from Patients with Cystic Fibrosis

et al. 2001

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“…A recent survey at the Hospital for Sick Children, Toronto, suggested that approximately 40% of a total of 500 CF patients are now colonized with this organism. The infection is believed to spread by nosocomial transmission (4,5) but once acquired, the clinical course is quite variable. Some patients show no particular alteration in the course oftheir disease, some show a mildly accelerated decline, while others succumb to a rapid decline in pulmonary function with fever, elevation oferythrocyte sedimentation rate, leukocytosis, and resistance to antibiotic therapy, culminating in death within several months to a year.…”

mentioning

confidence: 99%

Binding of Pseudomonas cepacia to normal human intestinal mucin and respiratory mucin from patients with cystic fibrosis.

Sajjan¹,

Corey²,

Karmali³

et al. 1992

J. Clin. Invest.

111

108

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Although not as prevalent as Pseudomonas aeruginosa, Pseudomonas cepacia is another opportunistic pathogen which colonizes the lungs of at least some patients with cystic fibrosis. A subgroup of these patients exhibits the "cepacia syndrome", i.e., a rapid clinical deterioration and death within one year. To investigate potential early sites of bacterial attachment, we have measured the specific binding of P. cepacia isolates from cystic fibrosis (CF) sputa to both CF and non-CF mucins purified from respiratory and intestinal secretions, respectively. As shown in microtiter binding assays, clinical isolates from 19/22 patients were found to bind to both mucins, with the highest specific binding exhibited by isolates from eight patients, seven of whom later died with the cepacia syndrome. No differences were observed in the binding capacity of the two (CF versus non-CF) mucins. Binding was specific, saturable, and not influenced by tetramethylurea, a disruptor of hydrophobic associations. Individual sugars were ineffective as hapten inhibitors, as were several lectins. Mucins treated by reduction/alkylation or chloroform/methanol extraction showed enhanced bacterial binding, findings which were attributed to exposure of underlying binding sites. Deglycosylation procedures indicated that mucin receptors for P. cepacia include N-acetylglucosamine and N-acetylgalactosamine, probably linked together as part of core oligosaccharide structures. P. cepacia isolates also bound to buccal epithelial cells, and mucin partially inhibited the binding of those isolates of P. cepacia that also had the ability to bind to mucin. We speculate that specific binding of P. cepacia to secreted mucins may be an early step in the pathogenesis of the cepacia syndrome. (J. Clin. Invest. 1992.89:648-656.)

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“…Pseudomonas cepacia (previously named Pseudomonus multivorans and "Pseudomonas kingae" is both a phytopathogen and, occasionally, a pathogen for humans (39). It is one of the major pulmonary pathogens in patients with cystic fibrosis (16,57). Simonsiella spp.…”

mentioning

confidence: 99%

Chromobacterium, Eikenella, Kingella, Neisseria, Simonsiella, and Vitreoscilla Species Comprise a Major Branch of the Beta Group Proteobacteria by 16S Ribosomal Ribonucleic Acid Sequence Comparison: Transfer of Eikenella and Simonsiella to the Family Neisseriaceae (emend.)

Dewhirst

Paster

Bright

1989

International Journal of Systematic Bacteriology

103

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Colonization of the Respiratory Tract with Pseudomonas cepacia in Cystic Fibrosis

Cited by 165 publications

References 6 publications

Identification and Antimicrobial Susceptibility of Alcaligenes xylosoxidans Isolated from Patients with Cystic Fibrosis

Identification and Antimicrobial Susceptibility of Alcaligenes xylosoxidans Isolated from Patients with Cystic Fibrosis

Binding of Pseudomonas cepacia to normal human intestinal mucin and respiratory mucin from patients with cystic fibrosis.

Chromobacterium, Eikenella, Kingella, Neisseria, Simonsiella, and Vitreoscilla Species Comprise a Major Branch of the Beta Group Proteobacteria by 16S Ribosomal Ribonucleic Acid Sequence Comparison: Transfer of Eikenella and Simonsiella to the Family Neisseriaceae (emend.)

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