The changing epidemiology of cystic fibrosis

FitzSimmons, Stacey C.

doi:10.1016/s0022-3476(05)83478-x

Cited by 860 publications

(402 citation statements)

References 12 publications

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“…77 Historically, significant improvements in patient longevity have been associated with the advent of antistaphylococcal therapy. 78 However, several published studies of the efficacy of prophylactic anti-staphylococcal antibiotics have not demonstrated clinical improvement in the treated populations. 79 80 Non-typeable H influenzae is also isolated from the respiratory tract early in the course of CF.…”

Section: Organismsmentioning

confidence: 99%

Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesis

Goss

Burns

2007

Thorax

397

364

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Section: Organismsmentioning

confidence: 99%

Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesis

Goss

Burns

2007

Thorax

397

364

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“…Chronic bacterial pulmonary infections are responsible for much of the morbidity and mortality in cystic fibrosis (CF) [1, 2]. Pseudomonas aeruginosa is the most common organism isolated from the sputum of adults with CF [3], with 80% of patients being infected by 18 years of age [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Adults with Cystic Fibrosis Infected with Antibiotic-Resistant <i>Pseudomonas aeruginosa</i>

et al. 2006

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Background: Although Pseudomonas aeruginosa is the most common bacterial infection in adults with cystic fibrosis and frequently develops resistance to multiple classes of antibiotics, it has not been determined whether patients with multiple antibiotic-resistant Pseudomonas aeruginosa have worse clinical outcomes than patients with more susceptible strains. Objectives: This study assessed the impact of multiply-resistant P. aeruginosa on lung function, hospitalizations, antibiotic use, lung transplantation and survival in adults with cystic fibrosis. Methods: In a cohort study at a university-based adult cystic fibrosis program, 75 consecutive adult cystic fibrosis patients who had P. aeruginosa isolated from sputum cultures were studied over a 4-year period. Outcomes included decline in FEV₁, clinic visits, hospitalizations, courses and days of intravenous antibiotics, and lung transplantation. Multiple linear and Poisson regression for repeated measures were used to assess the outcomes. Results: In comparison to patients with susceptible strains, patients with resistant P. aeruginosa had more severe baseline lung disease, more rapid decline in FEV₁ (160 ml/year, p = 0.003) and were significantly more likely to undergo lung transplantation (17.6 vs. 0%, p = 0.005). Conclusions: Infection with multiple-antibiotic-resistant P. aeruginosa is associated with accelerated progression of cystic fibrosis, and has important implications for infection control strategies, antibiotic use and lung transplantation.

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“…This killing has been attributed to various exoproducts of P. aeruginosa, including LasA protease (23), 4-hydroxy-2-heptylquinoline-N-oxide (HQNO) (24), the pel and psl products (25), and phenazines such as pyocyanin (26). It is widely accepted that P. aeruginosa uses these factors to compete with Gram-positive bacteria for the colonization of different niches (27,28). However, very little is known about the interactions of P. aeruginosa and S. aureus in the wound environment.…”

mentioning

confidence: 99%

Synergistic Interactions of Pseudomonas aeruginosa and Staphylococcus aureus in an In Vitro Wound Model

et al. 2014

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cIn individuals with polymicrobial infections, microbes often display synergistic interactions that can enhance their colonization, virulence, or persistence. One of the most prevalent types of polymicrobial infection occurs in chronic wounds, where Pseudomonas aeruginosa and Staphylococcus aureus are the two most common causes. Although they are the most commonly associated microbial species in wound infections, very little is known about their interspecies relationship. Evidence suggests that P. aeruginosa-S. aureus coinfections are more virulent than monoculture infection with either species; however, difficulties in growing these two pathogens together in vitro have hampered attempts to uncover the mechanisms involved. Here we describe a simple and clinically relevant in vitro wound model that supported concomitant growth of P. aeruginosa and S. aureus. We observed that the ability of P. aeruginosa and S. aureus to survive antibiotic treatment increased when they were grown together in planktonic cocultures and that antibiotic tolerance was further enhanced when they were grown together in the wound model. We attributed this enhanced tolerance to both the "host-derived" and "bacterium-derived" matrix components. Taken together, our data indicate that P. aeruginosa and S. aureus may benefit each other by coinfecting wounds and that the host-derived matrix may serve as important a role as the bacterium-derived matrix in protecting bacteria from some antibiotics.

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The changing epidemiology of cystic fibrosis

Cited by 860 publications

References 12 publications

Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesis

Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesis

Outcomes of Adults with Cystic Fibrosis Infected with Antibiotic-Resistant <i>Pseudomonas aeruginosa</i>

Synergistic Interactions of Pseudomonas aeruginosa and Staphylococcus aureus in an In Vitro Wound Model

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