scholarly journals Features of the treatment of the cystic fibrosis patient with mixed microbial respiratory infection, including Pandoraea Pnomenusa

Author(s):  
Olga I. Simonova ◽  
O. L. Voronina ◽  
Yu. V. Gorinova ◽  
E. L. Amelina ◽  
N. I. Burkina ◽  
...  

Respiratory tract infection is a major cause of complications and death in patients with cystic fibrosis (CF). Transmissible strains of Gram-negative non-fermenting Burkholderiales bacteria: Burkholderia cepacia complex, Achromobacter spp, Pandoraea spp. are quite alarming. In the paperfirstly there is presented a clinical case with mixed microbial infection of the CF patient with involvement of Pandoraea pnomenusa. There are reportedfeatures of diagnosis and treatment of a patient throughout 20 years, described the data of the examination of the patient and his airway microbiota. Timely identification of P. pnomenusa with the use of mass spectrometry MALDI-TOF and the molecular genetic techniques was shown to contribute to the isolation of the patient in the hospital, his transfer to the inpatient substitution therapy, that prevented the cross-infection of other CF patients. Permanent microbiological control revealed an increase of the antibiotic resistance of P. pnomenusa. The congruence of the antibiotic therapy with resistome of all identified microorganisms has allowed to develop an effective treatment schedule, which promoted to the elimination of P. aeruginosa and P. pnomenusa in the sputum of CF patients to minor amounts and preservation of this balance of microorganisms in the next six months.

2004 ◽  
Vol 53 (7) ◽  
pp. 663-668 ◽  
Author(s):  
Andrew McDowell ◽  
Eshwar Mahenthiralingam ◽  
Kerstin E.A. Dunbar ◽  
John E. Moore ◽  
Mary Crowe ◽  
...  

Studies of the prevalence of Burkholderia cepacia complex species amongst cystic fibrosis (CF) patients in different geographical regions, and the association between cross-infection and putative transmissibility markers, will further our understanding of these organisms and help to address infection-control issues. In this study, B. cepacia complex isolates from CF patients in different regions of Europe were analysed. Isolates were examined for B. cepacia complex species and putative transmissibility markers [cable pilin subunit gene (cblA) and the B. cepacia epidemic strain marker (BCESM)]. Sporadic and cross-infective strains were identified by random amplification of polymorphic DNA (RAPD). In total, 79 % of patients were infected with Burkholderia cenocepacia (genomovar III), 18 % with Burkholderia multivorans (genomovar II) and less than 5 % of patients with B. cepacia (genomovar I), Burkholderia stabilis (genomovar IV) or Burkholderia vietnamiensis (genomovar V). The cblA and BCESM transmissibility markers were only detected in strains of B. cenocepacia. The BCESM was a more sensitive marker for transmissible B. cenocepacia strains than cblA, although sporadic B. cenocepacia strains containing the BCESM, but lacking cblA, were also observed. Furthermore, clusters of cross-infection with transmissibility marker-negative strains of B. multivorans were identified. In conclusion, B. cenocepacia was the greatest cause of cross-infection, and the most widely distributed B. cepacia complex species, within these CF populations. However, cross-infection was not exclusive to B. cenocepacia and cblA and the BCESM were not absolute markers for transmissible B. cenocepacia, or other B. cepacia complex strains. It is therefore suggested that CF centres cohort patients based on the presence or absence of B. cepacia complex infection and not on the basis of transmissibility marker-positive B. cenocepacia as previously suggested.


2013 ◽  
Vol 31 (10) ◽  
pp. 665-668 ◽  
Author(s):  
Laura Barrado ◽  
M. Teresa Martinez ◽  
Jennifer Villa ◽  
M. Ángeles Orellana ◽  
Esther Viedma ◽  
...  

2002 ◽  
Vol 70 (5) ◽  
pp. 2715-2720 ◽  
Author(s):  
Karen K. Chu ◽  
Donald J. Davidson ◽  
T. Keith Halsey ◽  
Jacqueline W. Chung ◽  
David P. Speert

ABSTRACT Cystic fibrosis patients infected with strains from different genomovars of the Burkholderia cepacia complex can experience diverse clinical outcomes. To identify genomovar-specific determinants that might be responsible for these differences, we developed a pulmonary model of infection in BALB/c mice. Mice were rendered leukopenic by administration of cyclophosphamide prior to intranasal challenge with 1.6 × 104 bacteria. Five of six genomovar II strains persisted at stable numbers in the lungs until day 16 with minimal toxicity, whereas zero of seven genomovar III strains persisted but resulted in variable toxicity. We have developed a chronic pulmonary model of B. cepacia infection which reveals differences among genomovars in terms of clinical infection outcome.


2016 ◽  
Vol 31 (4) ◽  
pp. 106-111
Author(s):  
Vindana Chibabhai ◽  
Warren Lowman

Background: The epidemiology of cystic fibrosis (CF) associated pathogens other than Pseudomonas aeruginosa in the South African cystic fibrosis population has not been previously described.Methods: A retrospective review of respiratory cultures taken from cystic fibrosis clinic patients at the Charlotte Maxeke Johannesburg Academic Hospital from 2006 to 2010 was performed.Results: During the study period, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cepacia complex and Candida albicans prevalence remained stable, Aspergillus fumigatus increased from 8% to 20% (p = 0.0132); Staphylococcus aureus decreased from 66% to 50% (p = 0.0243) and Haemophilus influenzae decreased from 13% to 3% (p = 0.0136). There were significant antimicrobial susceptibility changes to meropenem (p  0.0001) amongst P. aeruginosa isolates and cloxacillin (p 0.0001) amongst S. aureus isolates. Prevalence of most bacterial pathogens appeared to increase with increasing age.Conclusion: The findings of this study illustrate the epidemiology of CF associated respiratory pathogens and the trends in prevalence and susceptibility patterns over a 5-year period.


2019 ◽  
Vol 63 (6) ◽  
Author(s):  
Vidya P. Narayanaswamy ◽  
Andrew P. Duncan ◽  
John J. LiPuma ◽  
William P. Wiesmann ◽  
Shenda M. Baker ◽  
...  

ABSTRACT Burkholderia cepacia complex (Bcc) lung infections in cystic fibrosis (CF) patients are often associated with a steady decline in lung function and death. The formation of biofilms and inherent multidrug resistance are virulence factors associated with Bcc infection and contribute to increased risk of mortality in CF patients. New therapeutic strategies targeting bacterial biofilms are anticipated to enhance antibiotic penetration and facilitate resolution of infection. Poly (acetyl, arginyl) glucosamine (PAAG) is a cationic glycopolymer therapeutic being developed to directly target biofilm integrity. In this study, 13 isolates from 7 species were examined, including Burkholderia multivorans, Burkholderia cenocepacia, Burkholderia gladioli, Burkholderia dolosa, Burkholderia vietnamiensis, and B. cepacia. These isolates were selected for their resistance to standard clinical antibiotics and their ability to form biofilms in vitro. Biofilm biomass was quantitated using static tissue culture plate (TCP) biofilm methods and a minimum biofilm eradication concentration (MBEC) assay. Confocal laser scanning microscopy (CLSM) visualized biofilm removal by PAAG during treatment. Both TCP and MBEC methods demonstrated a significant dose-dependent relationship with regard to biofilm removal by 50 to 200 μg/ml PAAG following a 1-h treatment (P < 0.01). A significant reduction in biofilm thickness was observed following a 10-min treatment of Bcc biofilms with PAAG compared to that with vehicle control (P < 0.001) in TCP, MBEC, and CLSM analyses. PAAG also rapidly permeabilizes bacteria within the first 10 min of treatment. Glycopolymers, such as PAAG, are a new class of large-molecule therapeutics that support the treatment of recalcitrant Bcc biofilm.


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