scholarly journals 1315. Ceftaroline Versus Vancomycin for the Treatment of Acute Pulmonary Exacerbations of Cystic Fibrosis in Adults

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S745-S746
Author(s):  
Marc Esquivel ◽  
Marguerite Monogue ◽  
Greg Smith ◽  
James D Finklea ◽  
James Sanders
Keyword(s):  
Cystic Fibrosis ◽  
Hospital Admission ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Safety And Efficacy ◽  
Clostridioides Difficile ◽  
Alternative Agent ◽  
Baseline Characteristics ◽  
Group B ◽  
Vancomycin Group

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent colonizer in cystic fibrosis (CF) patients that causes acute pulmonary exacerbation (APE). Vancomycin is the first line treatment for APE of CF; however, optimal alternatives remain poorly defined. The goal of this study was to determine the safety and efficacy of ceftaroline in CF patients presenting with an APE caused by MRSA. Methods This study was a single-center, retrospective cohort study from January 1, 2011 to January 1, 2020. The study included adult CF patients admitted for APE with %FEV1 > 10% lower than the patient’s baseline. A positive MRSA culture within 90 days before or 21 days after hospital admission and receipt of > 7 days of either vancomycin or ceftaroline was required for inclusion. Patients were excluded for receipt of a lung transplant, > 48 hours of alternative MRSA therapy, renal replacement therapy, or an APE secondary to fungal or mycobacterium infection. The primary outcome was the return to > 90% of baseline lung function measured by discharge %FEV1 in comparison to baseline %FEV1. Results Fifty-six patients were included in the analysis (22 ceftaroline; 34 vancomycin). There were no differences in baseline characteristics (Table 1). Eleven (50%) patients in the ceftaroline group and 19 (56%) in the vancomycin group met the primary outcome (P = 0.79) (Figure 1A). FEV1 measurements at baseline, admission, and discharge were not different between treatments (Figure 1B). Patients treated with ceftaroline had a longer length of stay during hospital admission, 14 days (IQR 13-14) vs.10 days (IQR 7-14), P = 0.01. Other secondary outcomes were similar between the ceftaroline and vancomycin groups, respectfully, including 30-day readmission rate, 6 (27%) vs. 12 (35%), P = 0.57; 30-day mortality, 0 (0%) vs. 2 (6%), P = 0.51; neutropenia 3 (12%) vs. 1 (3%), P = 0.29; Clostridioides difficile infection 0 (0%) vs. 1 (3%), P = >0.99; or acute kidney injury 2 (9%) vs. 5 (15%), P = 0.69. Table 1. Baseline characteristics for ceftaroline and vancomycin treated patients 1Lumacaftor/ivacaftor, tezacaftor/ivacaftor; 2Piperacillin/tazobactam, aminoglycoside, furosemide, contrast dye, lisinopril, NSAIDs, colistin, phenylephrine; 3Methimazole, sulfasalazine, trimethoprim/sulfamethoxazole; 4Albuterol, hypertonic saline, dornase alpha, azithromycin, ibuprofen, inhaled aminoglycoside, inhaled colistin, corticosteroid; 5Azithromycin, aminoglycoside, fluroquinolone, cephalosporin, carbapenem, piperacillin/tazobactam. Data represents n (%) unless noted. CFTR=cystic fibrosis transmembrane conductance regulator. Figure 1. %FEV1 trend from baseline to discharge in patients treated with ceftaroline or vancomycin (A) Percentage (%) of patients who met the primary outcome in each group; (B) Mean %FEV1 change between ceftaroline (square) and vancomycin (circle) with error bars representing standard deviations Conclusion This study found no difference in safety and efficacy outcomes between vancomycin and ceftaroline. Our small cohort supports ceftaroline as an alternative agent for the treatment of MRSA mediated APE of CF. Disclosures All Authors: No reported disclosures

scholarly journals P1869COFFEE INTAKE AND HEADACHE IN HAEMODIALYSIS (COFFEEHD TRIAL): A RANDOMIZED DOUBLE BLIND MULTICENTER CLINICAL TRIAL

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mabel Aoun ◽  
Najla Hilal ◽  
Beaini Chadia ◽  
Ghassan Sleilaty ◽  
Joseph Hajal ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Primary Outcome ◽  
Multicenter Trial ◽  
Ultrafiltration Rate ◽  
Double Blind ◽  
Caffeine Withdrawal ◽  
Decaffeinated Coffee ◽  
Group A ◽  
Baseline Characteristics ◽  
Group B

Abstract Background and Aims Coffee with its major component caffeine can enhance alertness and decrease tiredness and headache. Headache was reported in 40 to 75 % of hemodialysis patients. Caffeine circulates unbound in the blood and passes the dialysis membrane. Some authors suggested that headache can result from caffeine withdrawal. This study aims to compare the incidence of headache and hypotension between patients taking or not coffee during dialysis. Method This is a randomized double-blind multicenter trial. Patients of three hemodialysis units were included. Patients with atrial fibrillation were excluded. 156 patients were randomized to two groups, group A was given 80 cc of coffee and group B 80 cc of decaffeinated coffee in the middle of the session for 12 consecutive sessions. Ultrafiltration rate was fixed to a maximum of 13 ml/kg/h. The primary outcome was the incidence of headache and the secondary incidence of hypotension. This clinical trial received the approval of the ethics committee of Saint-Joseph University (HDF-1463) and was registered on ClinicalTrials.Gov (NCT04057313). Results A total of 139 patients completed the trial (6.4% vs 15.4 % of withdrawal in groups A and B respectively). Baseline characteristics are summarized in Table 1. The number of sessions with headache was not significantly different between group A and B (34% vs 37% respectively, p=0.522), nor the number of sessions with hypotension (27% vs 26% respectively, p= 0.539). In a subgroup analysis, headache was higher in group B (p=0.06) in two categories of patients: those with the highest potassium dialysate (K=2) and the non-hypertensive patients. Conclusion Headache occurred in 34 to 37% of dialysis sessions. There was no difference in headache or hypotensive episodes between patients in the coffee versus decaffeinated group.

scholarly journals The Involvement of Renal Capsule Is Associated With Acute Kidney Injury in Patients With Acute Pancreatitis

2021 ◽  
Vol 8 ◽  
Author(s):  
Mei Wei ◽  
Jingzhu Zhang ◽  
Cheng Qu ◽  
Yang Liu ◽  
Kun Gao ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Acute Pancreatitis ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Renal Capsule ◽  
Incidence And Mortality ◽  
Grade Ii ◽  
Baseline Characteristics ◽  
The Relationship ◽  
Grade Iii

Background: Acute pancreatitis (AP) is characterized by pancreatic/peripancreatic inflammation. Involvement of renal capsule refers to peripancreatic inflammation extending beyond the Gerota fascia and disappearance of renal rim sign (+) on CT images. However, its association with acute kidney injury (AKI), an important complication of AP, was rarely studied.Aim: This study aimed to assess the relationship between the involvement of renal capsule and AKI in a cohort of patients with AP.Methods: We retrospectively screened all the patients admitted for AP from January 2018 to December 2019. The involvement of renal capsule was judged by experienced radiologists according to the CT imaging. Propensity score matching (PSM) was used to control for biases in group sizes and baseline characteristics. The primary outcome was the development of AKI during the index admission. We also categorized the pararenal inflammation with the renal rim grade (RRG) and compared the incidence of AKI among different grades.Results: Involvement of renal capsule was identified in 71 of 503 patients (14.1%). The incidence of AKI was significantly higher in these patients when compared with the matched controls (43/71, 60.6% vs. 12/71, 16.9%, p < 0.001). Moreover, mortality also differed between groups (12.7% vs. 1.4%, p = 0.017). Multivariable logistic regression showed that renal capsule involvement is an independent risk factor of AKI (odds ratio, 4.355; 95% confidence interval, 1.434, 13.230, p = 0.009). Patients with RRG grade III had a significantly higher incidence of AKI than the other two grades (60.6% for Grade III, 17.1% for Grade II, and 3.8% for Grade I, p < 0.001).Conclusion: Involvement of renal capsule is associated with higher AKI incidence and mortality.

Transitioning From Consult-Based to Automatic Pharmacy-Driven Vancomycin Management: Results From a Single, Primary Care Center

2021 ◽  
pp. 089719002110041
Author(s):  
Jennifer L. Cole ◽  
Russell O’Glee ◽  
Michael Clark ◽  
Meredith White
Keyword(s):  
Primary Outcome ◽  
Care Center ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Management Policy ◽  
Primary Care Center ◽  
Safety And Efficacy ◽  
Policies And Procedures ◽  
Collaborative Agreement ◽  
Secondary Outcomes

Objective: The transition to area under the curve (AUC) vancomycin monitoring requires substantial updates in pharmacy policies and procedures. The study facility was tasked with transitioning from a consult-based collaborative agreement to an automatic pharmacist management policy on all intravenous (IV) vancomycin orders. The purpose of this quality assessment (QA) study was to evaluate the effectiveness of this transition. Methods: The primary outcome was the proportion of patients with pharmacist assessment of pharmacokinetics and dosing with documentation in IV vancomycin treated patients from January-June 2020. Secondary outcomes included the proportion of AUC24 levels within therapeutic range, the incidence of acute kidney injury (AKI) and treatment failures in patients treated ≥72 hours compared to a historical, trough-based cohort. Results: There were 88 patients in the QA analysis with 100% having a pharmacist assessment with documentation. There were 34 patients treated ≥72 hours in the AUC group, 36 in the trough-based group. AUC24 fell within desired range in 45% of monitored patients. Rates of AKI (9% vs 11%, p = 0.75) and treatment failures were similar (3% vs 0%, p = 0.3). Conclusion: The transition from consult-based to an automatic pharmacy management agreement was successful with similar safety and efficacy compared to a historical trough-based cohort.

scholarly journals Incidence of Acute Kidney Injury Among Infants in the Neonatal Intensive Care Unit Receiving Vancomycin With Either Piperacillin/Tazobactam or Cefepime

2020 ◽  
Vol 25 (6) ◽  
pp. 521-527
Author(s):  
Jenna W. Bartlett ◽  
Jessica Gillon ◽  
Jennifer Hale ◽  
Natalia Jimenez-Truque ◽  
Ritu Banerjee
Keyword(s):  
Acute Kidney Injury ◽  
Gestational Age ◽  
Retrospective Cohort ◽  
Neonatal Intensive Care ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Baseline Characteristics ◽  
Clinically Significant ◽  
Gestational Age At Birth ◽  
Age At Birth

OBJECTIVES To determine whether combination therapy with vancomycin and TZP is associated with a higher incidence of acute kidney injury (AKI) compared with vancomycin with cefepime in infants admitted to the NICU. METHODS This retrospective cohort study included infants in the NICU who received vancomycin/cefepime or vancomycin/TZP for at least 48 hours. The primary outcome was incidence of AKI, which was defined by the neonatal modified Kidney Disease Improving Global Outcomes AKI criteria. RESULTS Forty-two infants who received vancomycin with cefepime and 58 infants who received vancomycin with TZP were included in the analysis. The median gestational age at birth, birth weight, and dosing weight were lower in the TZP group, but other baseline characteristics were comparable, including corrected gestational age. Two patients (3%) receiving vancomycin/TZP versus 2 patients (5%) receiving vancomycin/cefepime met criteria for AKI during their antibiotic course (p = 1.00). There were no clinically significant changes in serum creatinine or urine output from baseline to the end of combination antibiotic treatment in either group. CONCLUSIONS Among infants admitted to our NICU, AKI incidence associated with vancomycin and either TZP or cefepime therapy was low and did not differ by antibiotic combination.

Rationale, baseline characteristics and methodology of the non-interventional VIVA study in postmenopausal osteoporosis

2014 ◽  
Vol 23 (01) ◽  
pp. 49-55
Author(s):  
L. C. Hofbauer ◽  
D. Felsenberg ◽  
M. Amling ◽  
A. Kurth ◽  
P. Hadji
Keyword(s):  
Quality Of Life ◽  
Postmenopausal Osteoporosis ◽  
Primary Outcome ◽  
Osteoporosis Treatment ◽  
Secondary Outcome ◽  
Matched Pairs ◽  
Fracture History ◽  
Baseline Characteristics ◽  
Study Inclusion

SummaryIt is important to understand compliance and persistence with medication use in the clinical practice of osteoporosis treatment. The purpose of this work is to describe the “intravenous ibandronate versus oral alendronate” (VIVA) study, a non-interventional trial to assess the compliance and persistence of osteopenic postmenopausal women with treatment via weekly oral alendronate or intravenous ibandronate (Bonviva®) every three months.4477 patients receiving ibandronate 3 mg i. v. quarterly and 1491 patients receiving alendronate 70 mg orally weekly were included in the study. Matched pairs of 901 subjects in each group were also generated. Matching was performed on the basis of age, body mass index, fracture history at study inclusion, prior treatment with bisphosphonates and the number of concomitant disorders. Secondary outcome measures of osteoporosis related fractures, mobility restriction and pain, analgesia, quality of life questionnaires as well as attitudes to medications were assessed. The primary outcome parameters of compliance and persistence will be tracked in these subjects.At baseline, the entire collectives differed significantly on body weight (less in ibandronate group), duration since osteo - porosis diagnosis (longer in ibandronate), and incidence of prior osteoporotic fracture (higher in ibandronate group). The matched-pairs differed only on mobility restriction and quality of life (both worse in ibandronate group).The results from the VIVA study trial will provide scientific rationale for clinical recommendations in the pharmacological treatment of postmenopausal osteoporosis.

scholarly journals Treatment with a DPP-4 inhibitor at time of hospital admission for COVID-19 is not associated with improved clinical outcomes: data from the COVID-PREDICT cohort study in The Netherlands

2021 ◽  
Author(s):  
Rick I. Meijer ◽  
Trynke Hoekstra ◽  
Niels C. Gritters van den Oever ◽  
Suat Simsek ◽  
Joop P. van den Bergh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Primary Outcome ◽  
Infectious Complications ◽  
Glucose Lowering ◽  
Diabetes Severity ◽  
Outcome Mortality

Abstract Purpose Inhibition of dipeptidyl peptidase (DPP-)4 could reduce coronavirus disease 2019 (COVID-19) severity by reducing inflammation and enhancing tissue repair beyond glucose lowering. We aimed to assess this in a prospective cohort study. Methods We studied in 565 patients with type 2 diabetes in the CovidPredict Clinical Course Cohort whether use of a DPP-4 inhibitor prior to hospital admission due to COVID-19 was associated with improved clinical outcomes. Using crude analyses and propensity score matching (on age, sex and BMI), 28 patients using a DPP-4 inhibitor were identified and compared to non-users. Results No differences were found in the primary outcome mortality (matched-analysis = odds-ratio: 0,94 [95% confidence interval: 0,69 – 1,28], p-value: 0,689) or any of the secondary outcomes (ICU admission, invasive ventilation, thrombotic events or infectious complications). Additional analyses comparing users of DPP-4 inhibitors with subgroups of non-users (subgroup 1: users of metformin and sulphonylurea; subgroup 2: users of any insulin combination), allowing to correct for diabetes severity, did not yield different results. Conclusions We conclude that outpatient use of a DPP-4 inhibitor does not affect the clinical outcomes of patients with type 2 diabetes who are hospitalized because of COVID-19 infection.

scholarly journals 1211. Response to Fecal Microbiota Transplant (FMT) in Refractory Clostridioides difficile Infection (CDI) is Modest Compared to Recurrent CDI in Hospitalized Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S627-S627
Author(s):  
Jae Hyun Shin ◽  
R Ann Hays ◽  
Cirle Warren
Keyword(s):  
Health System ◽  
Complete Resolution ◽  
Fecal Microbiota ◽  
Inpatient Setting ◽  
University Of Virginia ◽  
Cure Rate ◽  
Fecal Microbiota Transplant ◽  
Safety And Efficacy ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Abstract Background There are limited options for Clostridioides difficile infection (CDI) refractory to conventional antibiotic therapy (metronidazole, vancomycin, or fidaxomicin). Fecal microbiota transplant (FMT) is considered a safe and effective treatment for recurrent CDI but has not been widely utilized for refractory CDI due to concerns about safety. Even when included in studies, refractory CDI has not been analyzed separately from recurrent CDI. We reviewed cases of FMT performed in the inpatient setting for CDI to evaluate its safety and efficacy for refractory CDI. Methods Patients who received FMT inpatient at University of Virginia Health System for recurrent or refractory CDI after Infectious Diseases and Gastroenterology consultation signed informed consent acknowledging that FMT was considered investigational use in CDI not responding to standard of care as per 2014 FDA guidance. Charts were reviewed as part of quality improvement efforts to evaluate safety and efficacy of FMT in inpatient setting. Results Starting in July 2014, 13 patients received FMT for CDI as inpatients. Six received FMT for recurrent CDI, with four having complete resolution, one had recurrent CDI, and one had persistent C. difficile-negative diarrhea, for cure rate of 83%, comparable to published studies. Seven patients received FMT for refractory CDI, with three resulting in complete resolution. One responded to FMT but refused further care, one died from multiorgan failure after initial response to FMT that was possibly related to CDI, strongyloides, and/or CMV. Two patients had ongoing diarrhea suggestive of post-infectious irritable bowel syndrome, one was C. difficile-negative and one was not tested. The cure rate was 57%, lower than that of the recurrent CDI, but without any clear evidence of microbiologic failure. Outcome of patients undergoing FMT for CDI in the inpatient setting at University of Virginia Health System Conclusion Cure rate for FMT for refractory CDI was lower than recurrent CDI, but review of the cases of treatment failures did not reveal any microbiologic evidence of failure. FMT should be considered an alternative option when treating refractory CDI. Disclosures All Authors: No reported disclosures

scholarly journals Racial, ethnic and socioeconomic disparities in patients undergoing left atrial appendage closure

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318650
Author(s):  
Robbie Sparrow ◽  
Shubrandu Sanjoy ◽  
Yun-Hee Choi ◽  
Islam Y Elgendy ◽  
Hani Jneid ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Left Atrial Appendage ◽  
Kidney Injury ◽  
Complication Rates ◽  
Left Atrial Appendage Closure ◽  
Black Patients ◽  
Comorbidity Burden ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Major Adverse Events

ObjectiveThis manuscript aims to explore the impact of race/ethnicity and socioeconomic status on in-hospital complication rates after left atrial appendage closure (LAAC).MethodsThe US National Inpatient Sample was used to identify hospitalisations for LAAC between 1 October 2015 to 31 December 2018. These patients were stratified by race/ethnicity and quartiles of median neighbourhood income. The primary outcome was the occurrence of in-hospital major adverse events, defined as a composite of postprocedural bleeding, cardiac and vascular complications, acute kidney injury and ischaemic stroke.ResultsOf 6478 unweighted hospitalisations for LAAC, 58% were male and patients of black, Hispanic and ‘other’ race/ethnicity each comprised approximately 5% of the cohort. Adjusted by the older Americans population, the estimated number of LAAC procedures was 69.2/100 000 for white individuals, as compared with 29.5/100 000 for blacks, 47.2/100 000 for Hispanics and 40.7/100 000 for individuals of ‘other’ race/ethnicity. Black patients were ~5 years younger but had a higher comorbidity burden. The primary outcome occurred in 5% of patients and differed significantly between racial/ethnic groups (p<0.001) but not across neighbourhood income quartiles (p=0.88). After multilevel modelling, the overall rate of in-hospital major adverse events was higher in black patients as compared with whites (OR: 1.60, 95% CI 1.22 to 2.10, p<0.001); however, the incidence of acute kidney injury was higher in Hispanics (OR: 2.19, 95% CI 1.52 to 3.17, p<0.001). No significant differences were found in adjusted overall in-hospital complication rates between income quartiles.ConclusionIn this study assessing racial/ethnic disparities in patients undergoing LAAC, minorities are under-represented, specifically patients of black race/ethnicity. Compared with whites, black patients had higher comorbidity burden and higher rates of in-hospital complications. Lower socioeconomic status was not associated with complication rates.

scholarly journals Effects of different thermal insulation methods on the nasopharyngeal temperature in patients undergoing laparoscopic hysterectomy: a prospective randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guanyu Yang ◽  
Zefei Zhu ◽  
Hongyu Zheng ◽  
Shifeng He ◽  
Wanyue Zhang ◽  
...  
Keyword(s):  
Thermal Insulation ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Laparoscopic Hysterectomy ◽  
Control Group ◽  
Prospective Randomized Controlled Trial ◽  
Warming Blanket ◽  
Group A ◽  
Insulation Effect ◽  
Group B

Abstract Background This study explored the comparison of the thermal insulation effect of incubator to infusion thermometer in laparoscopic hysterectomy. Methods We assigned 75 patients enrolled in the study randomly to three groups: Group A: Used warming blanket; group B: Used warming blanket and infusion thermometer; group C: Used warming blanket and incubator. The nasopharyngeal temperature at different time points during the operation served as the primary outcome. Results The nasopharyngeal temperature of the infusion heating group was significantly higher than that of the incubator group 60 min from the beginning of surgery (T3): 36.10 ± 0.20 vs 35.81 ± 0.20 (P<0.001)90 min from the beginning of surgery (T4): 36.35 ± 0.20 vs 35.85 ± 0.17 (P<0.001). Besides, the nasopharyngeal temperature of the incubator group was significantly higher compared to that of the control group 60 min from the beginning of surgery (T3): 35.81 ± 0.20 vs 35.62 ± 0.18 (P<0.001); 90 min from the beginning of surgery (T4): 35.85 ± 0.17 vs 35.60 ± 0.17 (P<0.001). Regarding the wake-up time, that of the control group was significantly higher compared to the infusion heating group: 24 ± 4 vs 21 ± 4 (P = 0.004) and the incubator group: 24 ± 4 vs 22 ± 4 (P = 0.035). Conclusion Warming blanket (38 °C) combined infusion thermometer (37 °C) provides better perioperative thermal insulation. Hospitals without an infusion thermometer can opt for an incubator as a substitute. Trial registration This trial was registered with ChiCTR2000039162, 20 October 2020.

scholarly journals Anti-Pseudomonas aeruginosa antibody detection in patients with bronchiectasis without cystic fibrosis

Thorax ◽  
2001 ◽  
Vol 56 (9) ◽  
pp. 669-674
Author(s):  
E Caballero ◽  
M-E Drobnic ◽  
M-T Pérez ◽  
J-M Manresa ◽  
A Ferrer ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Outer Membrane ◽  
Outer Membrane Proteins ◽  
Antibody Detection ◽  
Individual Bands ◽  
Diagnostic Usefulness ◽  
Group A ◽  
Group B

BACKGROUNDPseudomonas aeruginosa is a frequent cause of infection in patients with bronchiectasis. Differentiation between non-infected patients and those with different degrees of P aeruginosainfection could influence the management and prognosis of these patients. The diagnostic usefulness of serum IgG antibodies againstP aeruginosa outer membrane proteins was determined in patients with bronchiectasis without cystic fibrosis.METHODSFifty six patients were classified according to sputum culture into three groups: group A (n=18) with no P aeruginosain any sample; group B (n=18) with P aeruginosa alternating with other microorganisms; and group C (n=20) with P aeruginosa in all sputum samples. Each patient had at least three sputum cultures in the 6 months prior to serum collection. Detection of antibodies was performed by Western blot and their presence against 20 protein bands (10–121 kd) was assessed.RESULTSAntibodies to more than four bands in total or to five individual bands (36, 26, 22, 20 or 18 kd) differentiated group B from group A, while antibodies to a total of more than eight bands or to 10 individual bands (104, 69, 63, 56, 50, 44, 30, 25, 22, 13 kd) differentiated group C from group B. When discordant results between the total number of bands and the frequency of P aeruginosa isolation were obtained, the follow up of patients suggested that the former, in most cases, predicted chronic P aeruginosacolonisation.CONCLUSIONIn patients with bronchiectasis the degree of P aeruginosa infection can be determined by the number and type of outer membrane protein bands indicating which serum antibodies are present.

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