Infection With Transmissible Strains of Pseudomonas aeruginosa and Clinical Outcomes in Adults With Cystic Fibrosis

2012 ◽  
Vol 2012 ◽  
pp. 540-542
Author(s):  
J.A. Stockman
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Clinical Outcomes

Persistency of Pseudomonas aeruginosa in sputum cultures and clinical outcomes in adult patients with cystic fibrosis

2011 ◽  
Vol 31 (7) ◽  
pp. 1603-1610 ◽  
Author(s):  
A. Burkett ◽  
K. L. Vandemheen ◽  
T. Giesbrecht-Lewis ◽  
K. Ramotar ◽  
W. Ferris ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Clinical Outcomes ◽  
Adult Patients

scholarly journals Most of Staphylococcus aureus and Pseudomonas aeruginosa co-infecting isolates coexist, a condition that may impact clinical outcomes in Cystic Fibrosis patients

2020 ◽  
Author(s):  
Paul Briaud ◽  
Sylvère Bastien ◽  
Laura Camus ◽  
Marie Boyadjian ◽  
Philippe Reix ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Multivariate Analysis ◽  
Natural History ◽  
Clinical Outcomes ◽  
Bacterial Colonization ◽  
Childhood And Adolescence ◽  
History Of

AbstractStaphylococcus aureus (SA) is the major colonizer of the lung of cystic fibrosis (CF) patient during childhood and adolescence. As patient aged, the prevalence of SA decreases and Pseudomonas aeruginosa (PA) becomes the major pathogen infecting adult lungs. Nonetheless, SA remains significant and patients harbouring both SA and PA are frequently found in worldwide cohort. Impact of coinfection remains controversial. Furthermore, co-infecting isolates may compete or coexist. The aim of this study was to analyse if co-infection and coexistence of SA and PA could lead to worse clinical outcomes. The clinical and bacteriological data of 212 Lyon CF patients were collected retrospectively, and patients were ranked into three groups, SA only (n=112), PA only (n=48) or SA plus PA (n=52). In addition, SA and PA isolates from co-infecting patients were tested in vitro to define their interaction profile. Sixty five percent (n=34) of SA/PA pairs coexist. Using univariate and multivariate analysis, we confirm that SA patients have a clinical condition less severe than others, and PA induce a poor outcome independently of the presence of SA. FEV1 is lower in patients infected by competition strain pairs than in those infected by coexisting strain pairs compared to SA mono-infection. Coexistence between SA and PA may be an important step in the natural history of lung bacterial colonization within CF patients.

scholarly journals Pseudomonas aeruginosa Susceptibility Patterns and Associated Clinical Outcomes in People with Cystic Fibrosis following Approval of Aztreonam Lysine for Inhalation

2020 ◽  
pp. AAC.02327-20 ◽  
Author(s):  
Claire L Keating ◽  
Jonathan B Zuckerman ◽  
Pradeep K Singh ◽  
Matthew McKevitt ◽  
Oksana Gurtovaya ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Lung Function ◽  
Clinical Outcomes ◽  
Primary Endpoint ◽  
The United States ◽  
Study Endpoint ◽  
Primary Study ◽  
Antibiotic Exposure ◽  
Pulmonary Exacerbations

Rationale: Approval of aztreonam lysine for inhalation solution (AZLI) raised concerns that additional antibiotic exposure would potentially affect susceptibility profiles of Pseudomonas aeruginosa (PA) isolates from cystic fibrosis (CF) patients.Objective: This 5-year, prospective, observational study tracked susceptibility changes and clinical outcomes in CF patients in the United States with chronic PA infection.Methods: Sputum cultures were collected annually (2011-2016). The primary study endpoint was the proportion of subjects whose least susceptible PA isolate had an aztreonam minimum inhibitory concentration (MIC) that was >8 μg/mL (parenteral breakpoint) and increased ≥4-fold compared with the least susceptible isolate from the previous year. Annualized data for pulmonary exacerbations, hospitalizations, and FEV1% predicted were obtained from the CF Foundation Patient Registry and compared between subjects meeting/not meeting the primary endpoint.Results: 510 subjects were enrolled; 334 (65%) completed the study. A consistent proportion of evaluable subjects (13-22%) met the primary endpoint each year; and AZLI use during the previous 12 months was not associated with meeting the primary endpoint. While the annual decline in lung function was comparable for subjects meeting/not meeting the primary endpoint, more pulmonary exacerbations and hospitalizations were experienced by those who met it.Conclusions: Aztreonam susceptibility of PA remained consistent during the 5-year study. The relationship between PA isolate susceptibilities and clinical outcomes is complex; reduced susceptibility was not associated with accelerated decline in lung function, but was associated with more exacerbations and hospitalizations, likely reflecting increased overall antibiotic exposure.

scholarly journals Infection With Transmissible Strains of Pseudomonas aeruginosa and Clinical Outcomes in Adults With Cystic Fibrosis

JAMA ◽  
2010 ◽  
Vol 304 (19) ◽  
pp. 2145 ◽  
Author(s):  
Shawn D. Aaron ◽  
Katherine L. Vandemheen ◽  
Karam Ramotar ◽  
Tracy Giesbrecht-Lewis ◽  
Elizabeth Tullis ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Clinical Outcomes

scholarly journals Epidemic Pseudomonas aeruginosa infection in patients with cystic fibrosis is not a risk factor for poor clinical Outcomes following lung transplantation

2016 ◽  
Vol 15 (3) ◽  
pp. 392-399 ◽  
Author(s):  
Julia Pritchard ◽  
Mitesh V. Thakrar ◽  
Ranjani Somayaji ◽  
Michael G. Surette ◽  
Harvey R. Rabin ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Lung Transplantation ◽  
Clinical Outcomes ◽  
Pseudomonas Aeruginosa Infection

scholarly journals 195. Antimicrobial Stewardship Incorporating New Antimicrobials for Use against Multi-Drug Resistant Pseudomonas aeruginosa in Cystic Fibrosis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S102-S102
Author(s):  
Jinhee Jo ◽  
Anne J Gonzales-Luna ◽  
Kevin W Garey
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Clinical Outcomes ◽  
Antimicrobial Stewardship ◽  
Medical Center ◽  
Descriptive Analysis ◽  
The United States ◽  
Forced Expiratory Volume ◽  
Exacerbation Rate ◽  
Patient Demographics

Abstract Background Cystic fibrosis (CF) is a life-limiting genetic disease affecting approximately 80,000 people worldwide, including 30,000 in the United States. Chronic Pseudomonas aeruginosa (PA) infections in CF often develop to be multidrug-resistant (MDR) and are associated with worse clinical outcomes. Ceftolozane/Tazobactam (C/T) has shown benefits over other standards of therapy in selected populations with MDR-PA infections, but studies are lacking in the CF population. The objective of this study was to evaluate the current use and antimicrobial stewardship of C/T in CF patients with MDR-PA. Methods This is a retrospective study of hospitalized CF patients with infections due to positive cultures for MDR-PA from 2016–2019 at Baylor St. Luke’s Medical Center in Houston, Texas. Electronic medical records were reviewed for patient demographics, presence of infectious diseases (ID) consult, antibiotics use, and clinical outcomes. A descriptive analysis was performed to compare the patient demographics and clinical outcomes between patients receiving C/T-based and non-C/T therapies. Results A total of 56 CF patients with positive MDR-PA cultures were identified (18 receiving C/T and 38 receiving non-C/T antibiotics). Most MDR-PA was cultured from the lungs (94.6%, 54/56). Patient age, weight, and body mass index were similar between those receiving C/T and non-C/T therapies as was the overall duration of antibiotic therapy 16.3 (± 8.7) vs. 13.9 (± 3.5) days in C/T and non-C/T groups, respectively. More patients in the C/T group had severe forced expiratory volume in 1 s (FEV1) [£40%] at baseline (66.7% vs. 21.1%) and higher ICU admission rates (44.4% vs 2.6%). All C/T patients had an ID consult placed (3 ± 3.1 days after admission) but none in the non-C/T group. The 30-day recurrent pulmonary exacerbation rate was comparable between C/T and non-C/T groups (22.2% vs. 15.8%). Conclusion C/T was reserved for the sickest group of CF patients with severe FEV1. Given the devastating disease progression with MDR organisms in CF, new antibiotics with better clinical outcomes against chronic MDR-PA should be considered earlier in therapy for this population. Larger studies are warranted to analyze cost-effectiveness and clinical outcomes. Disclosures Kevin W. Garey, PharMD, MS, FASHP, Merck & Co. (Grant/Research Support, Scientific Research Study Investigator)

Sign in / Sign up

Export Citation Format

Share Document