Early eradication of Pseudomonas aeruginosa infection in cystic fibrosis

Каширская, Н. Ю.; Амелина, Е. Л.; Красовский, С. А.

doi:10.18093/0869-0189-2017-27-1-81-86

Cited by 2 publications

(1 citation statement)

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“…При хронической синегнойной инфекции вне обострения бронхолегочного процесса рекомендуется ингаляционная АБТ c использованием ингаляционных аминогликозидов и/или полимиксинов (уровень доказательности А) [18][19][20][21].…”

Section: пульмонологияunclassified

Tobramycin Activity for Pseudomonas Aeruginosa spp. Isolated in Cystic Fibrosis Patients

Goryainova¹,

Поликарпова²,

Semykin³

et al. 2021

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Study Objective: To determine in vitro activity of Tobramycin for Pseudomonas aeruginosa spp. isolated in children with cystic fibrosis (CF); to retrospectively study the efficiency dynamics of inhalative Tobramycin in management of bronchopulmonary process exacerbation in children with CF aged 9 years old (2009–2018). Study Design: retrospective analysis. Materials and Methods. The study included 173 children with cystic fibrosis aged 3 to 17 years old; the median age in the general group was 11 [8; 15] years. Subjects were divided into two comparison groups, depending on various 14-day combined antipseudomonal therapy: 42 children were treated with Cefepime 150 mg/kg + Amikacin 20 mg/kg IV drop infusion; 48 subjects — with Meropenem 100 mg/kg + Amikacin 20 mg/kg IV drop infusion; 83 patients — with Ceftazidime 200 mg/kg IV + Tobramycin (Bramitob) 300 mg twice daily, inhalation + Ciprofloxacin per os 30–40 mg/kg. Study Results. After the two-week therapy of 83 children with Tobramycin inhalations plus oral Ciprofloxacin and Ceftazidime IV, 123 (82%) out of 150 pathogenic P. aeruginosa and Staphylococcus aureus spp. were eliminated (p < 0.001 when compared to bacteriologic test results of pre-therapy bronchial mucus). Comparison groups demonstrated statistically significantly lower number of such subjects: in Cefepime + Amikacin group, 32 (43.8%) out of 73 pathogenic P. aeruginosa and S. aureus spp. were eliminated; whereas in Meropenem + Amikacin group, only 28 (35.4%) pathogens were eliminated out of 79 species. Upon admission in 2013, 50 followed up children underwent antimicrobial therapy with inhalative Tobramycin using the same regimen as in 2009; the P. aeruginosa elimination was the same: 11 (18%) out of 61 pathogenic species remained viable, 50 (82%) species were eliminated, as demonstrated by control sputum. The difference between the number of P. aeruginosa and S. aureus colonies before and after therapy was statistically significant (p < 0.001). Practically the same result after the use of inhalative Tobramycin was observed in 2018: 14 (70%) out 20 children with P. aeruginosa spp. had their control sputum samples sanitised (p < 0.001). Conclusion. Despite a 20-year history of using in patients with cystic fibrosis, inhalative Tobramycin is still clinically efficient and potent for isolated P. aeruginosa as a component of primary eradication and management of chronic Pseudomonal lung infections. Keywords: cystic fibrosis, Pseudomonas aeruginosa, inhalative Tobramycin.

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Section: пульмонологияunclassified

Tobramycin Activity for Pseudomonas Aeruginosa spp. Isolated in Cystic Fibrosis Patients

Goryainova¹,

Поликарпова²,

Semykin³

et al. 2021

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Characteristics of CF patients over 18 years of age in the Republic of Tatarstan

Shakirova,

Gizatullina

2023

Medicinskij sovet

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Introduction. Cystic fibrosis is a hereditary disease characterized by the defeat of all exocrine glands, vital organs and systems. Currently, the life expectancy of patients with cystic fibrosis is increasing due to the development of new therapies.Goal. Analysis of the results of a comprehensive examination of patients with cystic fibrosis under the supervision of a pulmonologist of Republican Clinical Hospital (RCH) of the Ministry of Health of the Republic of Tatarstan.Materials and methods. The analysis of the database of patients with cystic fibrosis, older than 18 years, registered in the Regional Center of cystic fibrosis of the Republic of Tatarstan (RT).Results. As of April 2023, 47 patients over the age of 18 with a diagnosis of cystic fibrosis were registered in the RCH of the Ministry of Health of the Republic of Tatarstan. The diagnosis was made on the basis of a positive sweat sample and/or a genetic study. The age of patients is from 18 to 39 years (26.1 ± 1.1 years). Women – 49%, men – 51%. Median body weight – 51.5 kg, height – 165 cm, BMI – 18.05 kg/m2. 25 patients (53.2%) had a BMI of less than 18.5 kg/m2. Among patients in RT, the most common mutation is F508del. When assessing the microbiological profile of the respiratory tract, chronic infection was detected in 37 patients (78.7%). Ps. aeruginosa (66.0%) and S.aureus (35.6%) were the most frequently sown. The average FVC indicators were 72.6 ± 4.3% predicted values, the average FEV1 indicators were 61.6 ± 28.1% predicted values.Conclusion. On the territory of the Republic of Tatarstan in patients with cystic fibrosis, the F508del mutation was detected in 30 (66.7%) adult patients, 9 of whom receive targeted therapy elecsacaftor / tezacaftor / ivacaftor+ ivacaftor with a pronounced positive effect. The high incidence of P. aeruginosa infection (66.0%) and a decrease in respiratory function among adult patients indicate a more severe course of cystic fibrosis.

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Early eradication of Pseudomonas aeruginosa infection in cystic fibrosis

Cited by 2 publications

References 23 publications

Tobramycin Activity for Pseudomonas Aeruginosa spp. Isolated in Cystic Fibrosis Patients

Tobramycin Activity for Pseudomonas Aeruginosa spp. Isolated in Cystic Fibrosis Patients

Characteristics of CF patients over 18 years of age in the Republic of Tatarstan

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