The impact of colonization with therapy-resistant pathogens on the survival rate after lung transplantation (LUTX) in cystic fibrosis (CF)

2021 ◽  
Author(s):  
Bettina Weingard ◽  
Franziska C. Trudzinski ◽  
Sophie Schneitler ◽  
Sören Becker ◽  
Hans-Joachim Schäfers ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Survival Rate ◽  
Lung Transplantation ◽  
The Impact

Lung Transplantation in Cystic Fibrosis and the Impact of Extracorporeal Circulation

2018 ◽  
Vol 54 (6) ◽  
pp. 313-319
Author(s):  
Alberto Jauregui ◽  
Maria Deu ◽  
Laura Romero ◽  
Antonio Roman ◽  
Antonio Moreno ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Transplantation ◽  
Extracorporeal Circulation ◽  
The Impact

The impact of the high emergency lung transplantation program in cystic fibrosis in France: insight from a comparison with Canada

2021 ◽  
pp. 2100014
Author(s):  
Adèle Coriati ◽  
Jenna Sykes ◽  
Lydie Lemonnier ◽  
Xiayi Ma ◽  
Sanja Stanojevic ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Transplantation ◽  
Population Based ◽  
Transplant Survival ◽  
Post Transplant ◽  
Kaplan Meier ◽  
Before And After ◽  
Cumulative Incidence Curve ◽  
The Impact ◽  
To Receive

IntroductionFrance implemented a high emergency lung transplantation (HELT) program nationally in 2007. A similar program does not exist in Canada. The objectives of our study were to compare health outcomes within France as well as between Canada and France before and after the HELT program in a population with Cystic Fibrosis (CF).MethodsThis population-based cohort study utilised data from the French and Canadian CF registries. A cumulative incidence curve assessed time to transplant with death without transplant as competing risks. The Kaplan-Meier method was used to estimate post-transplant survival.ResultsBetween 2002 and 2016, there were 1075 (13.0%) people with CF in France and 555 (10.2%) people with CF in Canada who underwent lung transplantation. The proportion of lung transplant increased in France after the HELT program was initiated (4.5% versus 10.1%) whereas deaths pre-transplant decreased from 85.3% in the pre-HELT to 57.1% in the post-HELT period. Between 2008–2016, people in France were significantly more likely to receive a transplant (Hazard Ratio (HR) 1.56, 95% CI 1.37–1.77, p<0.001) than die (HR 0.55, 95% CI 0.46–0.66, p<0.001) compared to Canada. Post-transplant survival was similar between the countries and there was no difference in survival when comparing pre- and post-HELT period in France.ConclusionFollowing the implementation of the HELT program, people living with CF in France were more likely to receive a transplant than die. Post-transplant survival in the post-HELT period in France did not change compared to the pre-HELT period, despite potentially sicker patients being transplanted, and is comparable to Canada.

59: The Impact of Lung Transplantation on Cardiac Dysfunction in Patients with Cystic Fibrosis

2008 ◽  
Vol 27 (2) ◽  
pp. S81
Author(s):  
E.F. Nash ◽  
A.S. Coonar ◽  
D.H. Delgado ◽  
L.G. Singer ◽  
S. Keshavjee ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Transplantation ◽  
Cardiac Dysfunction ◽  
The Impact

scholarly journals Bacterial Re-Colonization Occurs Early after Lung Transplantation in Cystic Fibrosis Patients

2021 ◽  
Vol 10 (6) ◽  
pp. 1275
Author(s):  
Anna Engell Holm ◽  
Hans Henrik Lawaetz Schultz ◽  
Helle Krogh Johansen ◽  
Tania Pressler ◽  
Thomas Kromann Lund ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Transplantation ◽  
Burkholderia Cepacia ◽  
Bacterial Species ◽  
Positive Culture ◽  
Burkholderia Cepacia Complex ◽  
Achromobacter Xylosoxidans ◽  
Lung Function Decline ◽  
Before And After ◽  
The Impact

Most cystic fibrosis (CF) patients referred for lung transplantation are chronically infected with Gram-negative opportunistic pathogens. It is well known that chronic infections in CF patients have a significant impact on lung-function decline and survival before transplantation. The rate and timing of re-colonization after transplantation have been described, but the impact on survival after stratification of bacteria is not well elucidated. We did a single-center retrospective analysis of 99 consecutive CF patients who underwent lung transplantation since the beginning of the Copenhagen Lung Transplant program in 1992 until October 2014. Two patients were excluded due to re-transplantation. From the time of CF diagnosis, patients had monthly sputum cultures. After transplantation, CF-patients had bronchoscopy with bronchoalveolar lavage at 2, 4, 6 and 12 weeks and 6, 12, 18 and 24 months after transplantation, as well as sputum samples if relevant. Selected culture results prior to and after transplantation were stored. We focused on colonization with the most frequent bacteria: Pseudomonas aeruginosa (PA), Stenotrophomonas maltophilia (SM), Achromobacter xylosoxidans (AX) and Burkholderia cepacia complex (BCC). Pulsed-field gel electrophoresis (PFGE) was used to identify clonality of bacterial isolates obtained before and after lung transplantation. Time to re-colonization was defined as the time from transplantation to the first positive culture with the same species. Seventy-three out of 97 (75%) had sufficient culture data for analyses with a median of 7 (1–91) cultures available before and after transplantation. Median colonization-free survival time was 23 days until the first positive culture after transplantation. After 2 years, 59 patients (81%) were re-colonized, 33 (48.5%) with PA, 7 (10.3%) with SM, 12 (17.6%) with AX, and 7 (10.3%) with BCC. No difference in survival was observed between the patients colonized within the first 2 years and those not colonized. Re-colonization of bacteria in the lower airways occurred at a median of 23 days after transplantation in our cohort. In our patient cohort, survival was not influenced by re-colonization or bacterial species.

scholarly journals The Impact of an Efflux Pump Inhibitor on the Activity of Free and Liposomal Antibiotics against Pseudomonas aeruginosa

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 577
Author(s):  
Douweh Leyla Gbian ◽  
Abdelwahab Omri
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Efflux Pump ◽  
Antimicrobial Activities ◽  
Dilution Method ◽  
Efflux Pump Inhibitor ◽  
Signal Production ◽  
Lung Infections ◽  
The Impact ◽  
Microbroth Dilution

The eradication of Pseudomonas aeruginosa in cystic fibrosis patients has become continuously difficult due to its increased resistance to treatments. This study assessed the efficacy of free and liposomal gentamicin and erythromycin, combined with Phenylalanine arginine beta-naphthylamide (PABN), a broad-spectrum efflux pump inhibitor, against P. aeruginosa isolates. Liposomes were prepared and characterized for their sizes and encapsulation efficiencies. The antimicrobial activities of formulations were determined by the microbroth dilution method. Their activity on P. aeruginosa biofilms was assessed, and the effect of sub-inhibitory concentrations on bacterial virulence factors, quorum sensing (QS) signals and bacterial motility was also evaluated. The average diameters of liposomes were 562.67 ± 33.74 nm for gentamicin and 3086.35 ± 553.95 nm for erythromycin, with encapsulation efficiencies of 13.89 ± 1.54% and 51.58 ± 2.84%, respectively. Liposomes and PABN combinations potentiated antibiotics by reducing minimum inhibitory and bactericidal concentrations by 4–32 fold overall. The formulations significantly inhibited biofilm formation and differentially attenuated virulence factor production as well as motility. Unexpectedly, QS signal production was not affected by treatments. Taken together, the results indicate that PABN shows potential as an adjuvant of liposomal macrolides and aminoglycosides in the management of lung infections in cystic fibrosis patients.

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