Clinical Outcomes Associated With Escherichia coli Infections in Adults With Cystic Fibrosis: A Cohort Study

Abstract Background Analysis of “emerging” pathogens in cystic fibrosis (CF) lung disease has focused on unique pathogens that are rare in other human diseases or are drug resistant. Escherichia coli is recovered in the sputum of up to 25% of patients with CF, yet little is known about the epidemiology or clinical impact of infection. Methods We studied patients attending a Canadian adult CF clinic who had positive sputum cultures for E coli from 1978 to 2016. Infection was categorized as transient or persistent (≥3 positive sputum cultures, spanning >6 months). Those with persistent infection were matched 2:1 with age, sex, and time-period controls without history of E coli infection, and mixed-effects models were used to assess pulmonary exacerbation (PEx) frequency, lung function decline, hospitalization, and intravenous antibiotic days. Results Forty-five patients (12.3%) had E coli recovered from sputum samples between 1978 and 2016, and 18 patients (40%) developed persistent infection. Nine patients (24%) had PEx at incident infection, and increased bioburden was predictive of exacerbation (P = .03). Risk factors for persistent infection included lower nutritional status (P < .001) and lower lung function (P = .009), but chronic infection with Pseudomonas aeruginosa was protective. There was no difference in annual lung function decline, need for hospitalization or intravenous antibiotics, or risk of PEx in patients with persistent infection. Conclusions Persistent E coli infection was frequent and was more common in CF patients with low nutritional status and lung function. However, this does not predict clinical decline. Multicenter studies would allow better characterization of the epidemiology and clinical impact of E coli infection.

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Prevalence and Outcomes of Achromobacter Species Infections in Adults with Cystic Fibrosis: a North American Cohort Study

Journal of Clinical Microbiology ◽

10.1128/jcm.02556-16 ◽

2017 ◽

Vol 55 (7) ◽

pp. 2074-2085 ◽

Cited By ~ 25

Author(s):

B. D. Edwards ◽

J. Greysson-Wong ◽

R. Somayaji ◽

B. Waddell ◽

F. J. Whelan ◽

...

Keyword(s):

Cystic Fibrosis ◽

Lung Function ◽

Persistent Infection ◽

Lung Function Decline ◽

Multicenter Studies ◽

Content Type ◽

History Of ◽

Long Term Prognosis ◽

North American Cohort

ABSTRACTAchromobacterspecies are increasingly being detected in cystic fibrosis (CF) patients, with an unclear epidemiology and impact. We studied a cohort of patients attending a Canadian adult CF clinic who had positive sputum cultures forAchromobacterspecies in the period from 1984 to 2013. Infection was categorized as transient or persistent (≥50% positive cultures for 1 year). Those with persistent infection were matched 2:1 with age-, sex-, and time-matched controls without a history ofAchromobacterinfection, and mixed-effects models were used to assess pulmonary exacerbation (PEx) frequency and lung function decline. Isolates from a biobank were retrospectively assessed, identified to the species level bynrdAsequencing, and genotyped using pulsed-field gel electrophoresis (PFGE). Thirty-four patients (11% of those in our clinic), with a median age of 24 years (interquartile range [IQR], 20.3 to 29.8 years), developedAchromobacterinfection. Ten patients (29%) developed persistent infection. Persistence did not denote permanence, as most patients ultimately cleared infection, often after years. Patients were more likely to experience PEx at incident isolation than at prior or subsequent visits (odds ratio [OR], 2.7 [95% confidence interval {CI}, 1.2 to 6.7];P= 0.03). Following persistent infection, there was no difference in annual lung function decline (−1.08% [95% CI, −2.73 to 0.57%] versus −2.74% [95% CI, −4.02 to 1.46%];P= 0.12) or the odds of PEx (OR, 1.21 [95% CI, 0.45 to 3.28];P= 0.70). Differential virulence amongAchromobacterspecies was not observed, and no cases of transmission occurred. We demonstrated that incidentAchromobacterinfection was associated with a greater risk of PEx; however, neither transient nor chronic infection was associated with a worsened long-term prognosis. Large, multicenter studies are needed to clarify the clinical impact, natural history, and transmissibility ofAchromobacter.

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Comparison of Homozygous for Delta F508 Mutation Nutritional Status, Lung Function Outcomes, Bacterial Growth, Antibiotic Treatments and Therapeutic Outcomes between the Amish and Non-Amish in a Single Pediatric Cystic Fibrosis Centre: A Retrospective Case-Controlled Study

10.35248/2572-0775.19.4.151 ◽

2019 ◽

Vol 04 (02) ◽

Author(s):

Rajeswary Padman Padmalingam ◽

Denise Gilham ◽

Tina Laturner ◽

Alyaa Hussien ◽

Ron Jones ◽

...

Keyword(s):

Cystic Fibrosis ◽

Lung Function ◽

Nutritional Status ◽

Bacterial Growth ◽

Controlled Study ◽

Retrospective Case ◽

Therapeutic Outcomes ◽

Cystic Fibrosis Centre

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Correction: Pyrosequencing Unveils Cystic Fibrosis Lung Microbiome Differences Associated with a Severe Lung Function Decline

PLoS ONE ◽

10.1371/journal.pone.0160726 ◽

2016 ◽

Vol 11 (8) ◽

pp. e0160726 ◽

Cited By ~ 1

Author(s):

Giovanni Bacci ◽

Patrizia Paganin ◽

Loredana Lopez ◽

Chiara Vanni ◽

Claudia Dalmastri ◽

...

Keyword(s):

Cystic Fibrosis ◽

Lung Function ◽

Cystic Fibrosis Lung ◽

Lung Function Decline ◽

Lung Microbiome ◽

Severe Lung

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Increased rate of lung function decline in Australian adolescents with cystic fibrosis

Pediatric Pulmonology ◽

10.1002/ppul.22946 ◽

2013 ◽

Vol 49 (9) ◽

pp. 873-877 ◽

Cited By ~ 20

Author(s):

Liam Welsh ◽

Colin F. Robertson ◽

Sarath C. Ranganathan

Keyword(s):

Cystic Fibrosis ◽

Lung Function ◽

Lung Function Decline

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260 Predictors of lung function decline in cystic fibrosis

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(16)30498-2 ◽

2016 ◽

Vol 15 ◽

pp. S117-S118

Author(s):

F. Ferro ◽

F. Freitas ◽

C. Lopes ◽

R. Costa ◽

A. Pinto ◽

...

Keyword(s):

Cystic Fibrosis ◽

Lung Function ◽

Lung Function Decline

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Antibiogram of Diarrhoeagenic Escherichia coli Patients under Five Years Attending Selected Hospitals in Kaduna State, Nigeria

Journal of Advances in Microbiology ◽

10.9734/jamb/2019/v14i430073 ◽

2019 ◽

pp. 1-11

Author(s):

R. O. Chioma ◽

I. Mzungu ◽

J. B. Orpin

Keyword(s):

Escherichia Coli ◽

Nutritional Status ◽

Good Health ◽

Latex Agglutination ◽

Public Health Issue ◽

Chi Square ◽

Children Under Five ◽

E Coli ◽

Under Five ◽

Good Nutrition

Escherichia coli infections and poor nutritional status have implications on the growth and development of children under five years, physically, mentally and health wise with consequences such as diarrhoea, stunting, wasting, underweight and often times leading to death, depending on their severity. This study evaluated the antibiogram of Escherichia coli O157 and Verocytotoxigenic Escherichia coli (VTEC)and the nutritional status of diarrhoeic children under five years in Kaduna State, Nigeria, using Conventional isolation methods, latex agglutination tests, VTEC-ELISA tests, Chi-square (SPSS Version 19) and WHO Antro (Version 3.2.2). Purposive sampling was used to select 350 children presenting with diarrhoea in six government hospitals within the three senatorial zones of Kaduna State. The results obtained revealed that 76(21.7%) of the 350 stool samples were positive for E. coli and 28(36.8%) were positive for E. coli O157:H7serotype and 1(1.3%) verocytotoxigenic E. coli (VTEC) serotype. High susceptibility to ciprofloxacin, chloramphenicol and high resistance to sulphamethoxazole, cefotaxime, amoxicillin, gentamicin and tetracycline by the isolates were observed. The study concluded that antibiotics have not been very effective in the treatment of E. coli-related diarrhoea, with VTEC now emerging in this part of the world, making it a serious public health issue. The study therefore recommends the implementation of programmes geared towards good hygiene, good nutrition and good health.

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