Staphylococcus aureus Small-Colony Variants Are Independently Associated With Worse Lung Disease in Children With Cystic Fibrosis

Wolter, Daniel J.; Emerson, Julia; McNamara, Sharon; Buccat, Anne Marie; Qin, Xuan; Cochrane, Elizabeth; Houston, L. L.; Rogers, Geraint B.; Marsh, Peter; Prehar, K.; Pope, Charles E.; Blackledge, Marcella; Déziel, Éric; Bruce, Kenneth D.; Ramsey, Bonnie W.; Gibson, Ronald L.; Burns, Jane L.; Hoffman, Lucas R.

doi:10.1093/cid/cit270

Cited by 164 publications

(149 citation statements)

References 27 publications

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“…In a CF center in the United States, 100 children with CF, of whom 24 had SCV S. aureus, were followed for an average of 1.7 years. 95 Those with SCV strains had lower lung function at the beginning and end of the study, but they had a similar rate of pulmonary exacerbations. Notably, 33% of the children with SCV strains did not have normal-colony S. aureus strains, which suggests that these children would not have been identified as infected with S. aureus had SCV strains not been sought.…”

Section: Ic4 Small Colony Variant (Scv) S Aureusmentioning

confidence: 90%

“…Notably, 33% of the children with SCV strains did not have normal-colony S. aureus strains, which suggests that these children would not have been identified as infected with S. aureus had SCV strains not been sought. 95 In addition, 2 pairs of subjects had the same SCV strains, suggesting possible transmission of SCVs between children with CF.…”

Section: Ic4 Small Colony Variant (Scv) S Aureusmentioning

confidence: 99%

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Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

352

382

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The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.

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Section: Ic4 Small Colony Variant (Scv) S Aureusmentioning

confidence: 90%

Section: Ic4 Small Colony Variant (Scv) S Aureusmentioning

confidence: 99%

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Saiman

Siegel

LiPuma

et al. 2014

Infect. Control Hosp. Epidemiol.

352

382

View full text Add to dashboard Cite

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“…Displacement of the natural upper airway microbes (Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus) by Pa is a hallmark of CF pulmonary disease progression (O'Sullivan & Freedman, 2009). Deep airway infections due to S. aureus and other oral organisms have also been shown to contribute to the microbial burden and inflammation that causes a decline in respiratory function (Flume & Van Devanter, 2012;Foweraker, 2009;Wolter et al, 2013). However, 60-85% of the CF population is colonized by Pa (FitzSimmons, 1993;Mahadeva et al, 1998).…”

Section: Clinical Characteristics Of Pseudomonal Infection In the Airmentioning

confidence: 99%

“…Auxotrophy associated with bacterial small-colony-variants in other chronic infections: a sign of bacterial endosymbiosis Bacterial small-colony-variants (SCV) isolates of S. aureus, S. maltophilia, and B. cepacia have frequently been found in the airway secretions of CF patients (Anderson et al, 2007;Haussler et al, 1999Haussler et al, , 2003aProctor et al, 2006;Wolter et al, 2013). Moreover, many examples of bacterial SCV associated chronic infections other than CF suggest translocation of bacterial commensals to otherwise ''sterile'' anatomic environments, even in immunocompetent hosts who have received adequate antimicrobial treatment.…”

Section: Cf Pa Evasion Of Host Defenses By Inactivation Of Arginine Bmentioning

confidence: 99%

Chronic pulmonary pseudomonal infection in patients with cystic fibrosis: A model for early phase symbiotic evolution

Qin

2014

Critical Reviews in Microbiology

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To cite this article: Xuan Qin (2016) Chronic pulmonary pseudomonal infection in patients with cystic fibrosis: A model for early phase symbiotic evolution, Critical Reviews in Microbiology, 42:1, 144-157, DOI: 10.3109/1040841X.2014 AbstractGain of ''antimicrobial resistance'' and ''adaptive virulence'' has been the dominant view of Pseudomonas aeruginosa (Pa) in cystic fibrosis (CF) in the progressively damaged host airway over the course of this chronic infection. However, the pathogenic effects of CF airway-adapted Pa strains are notably reduced. We propose that CF Pa and other bacterial cohabitants undergo host adaptation which resembles the changes found in bacterial symbionts in animal hosts. Development of clonally selected and intraspecific isogenic Pa strains which display divergent colony morphology, growth rate, auxotrophy, and antibiotic susceptibility in vitro suggests an adaptive sequence of infective exploitation-parasitism-symbiotic evolution driven by host defenses. Most importantly, the emergence of CF pseudomonal auxotrophy is frequently associated with a few specific amino acids. The selective retention or loss of specific amino acid biosynthesis in CF-adapted Pa reflects bacterium-host symbiosis and coevolution during chronic infection, not nutrient availability. This principle also argues against the long-standing concept of dietary availability leading to evolution of essential amino acid requirements in humans. A novel model of pseudomonal adaptation through multicellular bacterial syntrophy is proposed to explain early events in bacterial gene decay and decreased (not increased) virulence due to symbiotic response to host defense.

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“…It is important to use special culture conditions for the isolation of SCVs, because these phenotypes are easily overgrown on standard agar by cocolonizing bacteria due to their slow growth and their small colony size and are therefore difficult to isolate. Furthermore, it is of special interest to improve culture conditions for these phenotypes, because they are associated with chronic or persistent infections and with decreased pulmonary function and are more resistant to antibiotics than the normal phenotype (9)(10)(11)(12)(13)(14). Whereas all laboratories reported that they informed the clinic about pathogens with mucoid phenotypes, the culture of SCVs was reported by only 70% of investigators.…”

mentioning

confidence: 99%

Assessment of Microbiological Diagnostic Procedures for Respiratory Specimens from Cystic Fibrosis Patients in German Laboratories by Use of a Questionnaire

Peters

Kahl

2014

J Clin Microbiol

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Respiratory specimens from cystic fibrosis (CF) patients challenge microbiological laboratories with their complexity of pathogens and atypical variants. We evaluated the diagnostic procedures in German laboratories by use of a questionnaire. Although most laboratories followed guidelines, some of them served only a small number of patients, while others did not use the recommended selective agars to culture the particular CF-relevant species. C ystic fibrosis (CF) patients suffer from chronic recurrent airway infections, which cause phenotypical changes (small-colony variants [SCVs]; mucoid phenotypes) of typical CF pathogens and the selection of multiresistant and rare bacteria such as Burkholderia cepacia complex (BCC) or nontuberculous mycobacteria due to repeated antimicrobial therapies and adaptation of the bacteria to this particular niche. To provide optimal microbiological diagnostic special culture conditions, knowledge and experience about the typical CF pathogens and their phenotypical changes are required.(Part of this work was presented at the Annual Meeting of the German Society for Hygiene and Microbiology, 2012, Hamburg, Germany [CFP01].)The status of the microbiological diagnostic procedures of laboratories serving CF centers, which participate in the German "Quality assurance cystic fibrosis project" (1), was evaluated by use of a questionnaire. First, contributing CF centers were asked to provide the address of their microbiological laboratories. Second, a questionnaire based on the German microbiological infectious quality standards for airway infections in CF (Mikrobiologischinfektiologische Qualitätsstandards [MiQ]) (2) which were published by the German Society for Hygiene and Microbiology (3) and on the protocols provided by the consultant laboratories for CF microbiology (Institute of Microbiology, Medical School Hannover, Hannover, Germany; Max von Pettenkofer-Institute for Hygiene and Medical Microbiology, Munich, Germany) was sent to the laboratories. A translation of the main recommendations by the MiQ, which are comparable to the guidelines of the UK Cystic Fibrosis Trust (4) is provided in the supplemental material (see Table S1 in the supplemental material).Seventy-eight of 83 (94%) CF centers provided the address of the microbiological laboratory, and all these laboratories were contacted. Forty-five of 61 (74%) laboratories responsible for the microbiological testing of 4,664 CF patients (56% of CF patients in Germany in 2010) responded to the questionnaire. Eight laboratories (18%) provide microbiological service for less than 25 CF patients. Eighty-nine percent of the laboratories reported that they used guidelines, and most of them used the MiQ (88%).All laboratories used media to culture the most prevalent CF pathogens such as Haemophilus influenzae, Staphylococcus aureus, and Pseudomonas aeruginosa, supportively and/or selectively (Table 1) (2). Some reported the use of more than one medium.Thirteen laboratories used mannitol salt agar as a selective agar for S. aureus, a...

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Staphylococcus aureus Small-Colony Variants Are Independently Associated With Worse Lung Disease in Children With Cystic Fibrosis

Cited by 164 publications

References 27 publications

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Chronic pulmonary pseudomonal infection in patients with cystic fibrosis: A model for early phase symbiotic evolution

Assessment of Microbiological Diagnostic Procedures for Respiratory Specimens from Cystic Fibrosis Patients in German Laboratories by Use of a Questionnaire

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