Treatment of Lower Respiratory Tract Infections Due to Pseudomonas aeruginosa in Patients with Cystic Fibrosis

1985 ◽  
Vol 7 (Supplement_4) ◽  
pp. S669-S674 ◽  
Author(s):  
Brian E. Scully ◽  
Celia N. Ores ◽  
Alice S. Prince ◽  
Harold C. Neu
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

scholarly journals Comparative characteristics and clinical presentation of cystic fibrosis in adults with chronic lower respiratory tract infections with Pseudomonas aeruginosa and other non-fermenting gram-negative bacilli

2020 ◽  
Vol 4 (4) ◽  
pp. 186-191
Author(s):  
V.R. Makhmutova ◽  
◽  
T.E. Gembitskaya ◽  
A.G. Chermenskiy ◽  
O.N. Titova ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Respiratory Tract ◽  
Burkholderia Cepacia ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Gram Negative ◽  
Pseudomonas Infection ◽  
Tract Infections

Background: in Russia, the life expectancy of cystic fibrosis (CF) patients increased by 10 years in 2011–2017 being 55.49 years in 2017. However, the number of patients with the chronic infection caused by non-fermenting gram-negative bacilli (NFGNB), e.g., Burkholderia cepacia, Achromobacter spp. etc., increased as well. Aim: to evaluate the differences in the nutritional and functional status and the severity of mutations in CF patients with chronic Pseudomonas infection or NFGNB infection and to assess the sensitivity of P. aeruginosa to tobramycin in CF patients in the Northwest region of Russia. Patients and Methods: 31 patients with CF aged 18–43 years (18 men and 13 women) were examined. The duration of the study was 12 months. Spirometry, anthropometry, and sputum culture were performed. Results: P. aeruginosa alone was isolated in 18 patients (58%), Achromobacter spp. in 9 patients (29%), and Burkholderia spp. in 4 patients (13%). The patients were divided into two groups, i.e., patients with chronic Pseudomonas infection (group 1, n=18, 10 out of 18 patients with mucoid strains of P. aeruginosa) or chronic NFGNB infection (group 2, n=13). The median age and the mode age were 27 years and 27 years, respectively, in group 1 and 24 years and 22 years, respectively, in group 2. It was demonstrated that CF patients with chronic NFGNB infection are characterized by poorer nutritional status (p<0.05) but similar functional status and the severity of CFTR gene mutation compared to CF patients with chronic Pseudomonas infection. It was also shown that Р. aeruginosa is highly sensitive to tobramycin (94.4%). Conclusions: in CF patients, chronic lower respiratory tract infections with Burkholderia cepacia and Achromobacter spp. account for 41.9% of gram-negative rod infections. Further studies and drug sensitivity monitoring are needed. KEYWORDS: cystic fibrosis, DNA test, chronic infection with Pseudomonas aeruginosa, Burkholderia cepacia, Achromobacter spp, non-fermenting gram-negative bacilli, CFTR mutation, nutritional status, pulmonary function tests, inhaled antibiotic therapy. FOR CITATION: Makhmutova V.R., Gembitskaya T.E., Chermenskiy A.G. et al. Comparative characteristics and clinical presentation of cystic fibrosis in adults with chronic lower respiratory tract infections with Pseudomonas aeruginosa and other non-fermenting gram-negative bacilli. Russian Medical Inquiry. 2020;4(4):186–191. DOI: 10.32364/2587-6821-2020-4-4-186-191.

scholarly journals Predominance of Bacterial Flora Causing Lower Respiratory Tract Infections Following Tracheostomy in Patients of Chettinad Hospital & Research Institute, Chennai, India

2021 ◽  
Vol 10 (35) ◽  
pp. 2964-2968
Author(s):  
Swetha Thirumurthi ◽  
Priya Kanagamuthu ◽  
Rajasekaran Srinivasan ◽  
Bhalaji Dhanasekaran
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Sensitivity ◽  
Klebsiella Pneumonia ◽  
Lower Respiratory Tract Infections ◽  
Empirical Antibiotics ◽  
Tract Infections ◽  
Research Institute

BACKGROUND The term tracheostomy refers to forming an opening in the trachea.1,2 Its advantages include easy and direct access to lower respiratory tract, reduced risk of aspiration, faster weaning from ventilation support and improved physical and psychological comfort. But a common problem in tracheostomised patients is increased risk of colonisation of lower respiratory tract by exogenous bacteria because of direct exposure.1,3 This study was done to recognise pathogens in tracheal secretions collected from tracheostomised patients and their antibiotic sensitivity to treat them with appropriate antibiotics. METHODS This prospective study was done in 138 tracheostomised patients from October 2020 to March 2021 in intensive care unit (ICU) of Chettinad Hospital and Research Institute. Under sterile aseptic precautions, Day 0 and Day 7 cultures posttracheostomy was obtained and their antibiotic sensitivity was studied. Data was analysed using Statistical Package for Social Sciences (SPSS version 19) and presented in proportion, mean and standard deviation (Descriptive statistics). RESULTS In this study, of the 56 cases who had growth in their culture and sensitivity reports on day 0, the most common organism was Pseudomonas aeruginosa (33.9 %) sensitive to imipenem (94.7 %) followed by klebsiella (25 %) sensitive to teicoplanin, vancomycin, amikacin, cefoperazone/tazobactam, linezolid and piperacillin/tazobactam. On day 7, the growth of organisms isolated in tracheal culture got reduced from 56 cases to 16 cases. The prevalence of Pseudomonas reduced to 18.8 % in day 7 whereas Klebsiella pneumonia and Acinetobacter remained almost same from day 0 to day 7. CONCLUSIONS This study concludes the predominant pathogen as Pseudomonas aeruginosa with sensitivity to imipenem followed by Klebsiella with sensitivity to teicoplanin, vancomycin, amikacin, cefoperazone/tazobactam, linezolid and piperacillin/tazobactam on day 0 with reduction in the number of organisms on day 7 due to the fact that all our patients were admitted in ICU several days prior to tracheostomy and were started on antibiotics soon after admission as per choice of the treating physician. Hence, a clear understanding of bacterial colonisation post tracheostomy and its change in course is essential for timely intervention with empirical antibiotics for reducing the incidence of lower respiratory tract infections after tracheostomy in future. KEY WORDS Tracheostomy, Lower Respiratory Tract Infections, Pseudomonas Aeruginosa, Empirical Antibiotics.

scholarly journals Concordance between upper and lower airway microbiota in infants with cystic fibrosis

2017 ◽  
Vol 49 (3) ◽  
pp. 1602235 ◽  
Author(s):  
Sabine M.P.J. Prevaes ◽  
Wouter A.A. de Steenhuijsen Piters ◽  
Karin M. de Winter-de Groot ◽  
Hettie M. Janssens ◽  
Gerdien A. Tramper-Stranders ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Airway ◽  
Upper Respiratory Tract ◽  
Lower Respiratory Tract Infections ◽  
Rrna Sequencing ◽  
Upper Respiratory ◽  
Tract Infections

Nasopharyngeal and oropharyngeal samples are commonly used to direct therapy for lower respiratory tract infections in non-expectorating infants with cystic fibrosis (CF).We aimed to investigate the concordance between the bacterial community compositions of 25 sets of nasopharyngeal, oropharyngeal and bronchoalveolar lavage (BAL) samples from 17 infants with CF aged ∼5 months (n=13) and ∼12 months (n=12) using conventional culturing and 16S-rRNA sequencing.Clustering analyses demonstrated that BAL microbiota profiles were in general characterised by a mixture of oral and nasopharyngeal bacteria, including commensals like Streptococcus, Neisseria, Veillonella and Rothia spp. and potential pathogens like Staphylococcus aureus, Haemophilus influenzae and Moraxella spp. Within each individual, however, the degree of concordance differed between microbiota of both upper respiratory tract niches and the corresponding BAL.The inconsistent intra-individual concordance between microbiota of the upper and lower respiratory niches suggests that the lungs of infants with CF may have their own microbiome that seems seeded by, but is not identical to, the upper respiratory tract microbiome.

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