scholarly journals Features of the course and eradication of multidrug-resistant Pseudomonas aeruginosa infection in cystic fibrosis: clinical case

2021 ◽  
pp. 166-173
Author(s):  
E. I. Kondratyeva ◽  
E. V. Loshkova ◽  
E. D. Nikolaeva ◽  
M. M. Khachiyan ◽  
G. N. Yankina
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Nutritional Status ◽  
Respiratory Function ◽  
Clinical Case ◽  
Multidrug Resistant ◽  
Antibiotic Resistant ◽  
Pseudomonas Aeruginosa Infection ◽  
Resistant Strains ◽  
Chronic Lung Infection

Chronic lung infection caused by Pseudomonas aeruginosa reduces respiratory function and life expectancy in people with cystic fibrosis. Up to 2/3 of hospitalized patients, have antibiotic-resistant strains of Pseudomonas aeruginosa, which presents significant difficulties in prescribing eradication antibiotic therapy, which in some cases is aggravated by undesirable side effects of antimicrobial chemotherapy. The nutritional status of patients with cystic fibrosis is directly related to the activity of chronic pulmonary infection and the frequency of pulmonary exacerbations. A clinical example discusses the tactics of prescribing an alternative inhaled antibiotic aztreonam lysine (Cayston (Aztreonam lysine), Gilead Sciences Inc.) active against carbapenemases, including metallobetalactamases, in a patient with multidrug-resistant Pseudomonas aeruginosa. The clinical case demonstrates the successful eradication of the multidrug-resistant biotypes of Pseudomonas aeruginosa, and, as a consequence, the improvement of respiratory function and nutritional status, including the normalization of the 25(OH)D level in the patient.

scholarly journals Multidrug-Resistant Pseudomonas aeruginosa Infection in a Child with Cystic Fibrosis

2016 ◽  
Vol 60 (10) ◽  
pp. 5627-5630 ◽  
Author(s):  
Jocelyn Y. Ang ◽  
Nahed Abdel-Haq ◽  
Frank Zhu ◽  
Abrar K. Thabit ◽  
David P. Nicolau ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Cystic Fibrosis Patient ◽  
Multidrug Resistant ◽  
Pulmonary Exacerbation ◽  
Content Type ◽  
Pseudomonas Aeruginosa Infection

ABSTRACTWe describe a pediatric cystic fibrosis patient who developed a pulmonary exacerbation due to two multidrug-resistant (MDR)Pseudomonas aeruginosaisolates. In addition to these MDR organisms, the case was further complicated by β-lactam allergy. Despite the MDR phenotype, both isolates were susceptible to an antimicrobial combination.

scholarly journals Aerosolized Bovine Lactoferrin Counteracts Infection, Inflammation and Iron Dysbalance in A Cystic Fibrosis Mouse Model of Pseudomonas aeruginosa Chronic Lung Infection

2019 ◽  
Vol 20 (9) ◽  
pp. 2128 ◽  
Author(s):  
Antimo Cutone ◽  
Maria Stefania Lepanto ◽  
Luigi Rosa ◽  
Mellani Jinnett Scotti ◽  
Alice Rossi ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Genetic Disorder ◽  
Bacterial Load ◽  
Lung Infection ◽  
Multidrug Resistant ◽  
Bovine Lactoferrin ◽  
Lung Pathology ◽  
Iron Storage ◽  
Chronic Lung Infection

Cystic fibrosis (CF) is a genetic disorder affecting several organs including airways. Bacterial infection, inflammation and iron dysbalance play a major role in the chronicity and severity of the lung pathology. The aim of this study was to investigate the effect of lactoferrin (Lf), a multifunctional iron-chelating glycoprotein of innate immunity, in a CF murine model of Pseudomonas aeruginosa chronic lung infection. To induce chronic lung infection, C57BL/6 mice, either cystic fibrosis transmembrane conductance regulator (CFTR)-deficient (Cftrtm1UNCTgN(FABPCFTR)#Jaw) or wild-type (WT), were intra-tracheally inoculated with multidrug-resistant MDR-RP73 P. aeruginosa embedded in agar beads. Treatments with aerosolized bovine Lf (bLf) or saline were started five minutes after infection and repeated daily for six days. Our results demonstrated that aerosolized bLf was effective in significantly reducing both pulmonary bacterial load and infiltrated leukocytes in infected CF mice. Furthermore, for the first time, we showed that bLf reduced pulmonary iron overload, in both WT and CF mice. In particular, at molecular level, a significant decrease of both the iron exporter ferroportin and iron storage ferritin, as well as luminal iron content was observed. Overall, bLf acts as a potent multi-targeting agent able to break the vicious cycle induced by P. aeruginosa, inflammation and iron dysbalance, thus mitigating the severity of CF-related pathology and sequelae.

scholarly journals In Vitro Activity of Doripenem (S-4661) against Multidrug-Resistant Gram-Negative Bacilli Isolated from Patients with Cystic Fibrosis

2005 ◽  
Vol 49 (6) ◽  
pp. 2510-2511 ◽  
Author(s):  
Yunhua Chen ◽  
Elizabeth Garber ◽  
Qiuqu Zhao ◽  
Yigong Ge ◽  
Matthew A. Wikler ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Burkholderia Cepacia ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Vitro Activity ◽  
In Vitro Activity ◽  
Gram Negative ◽  
Resistant Strains

ABSTRACT Doripenem 50% inhibitory concentrations (MIC50) and 90% inhibitory concentrations (MIC90) for multidrug-resistant strains of mucoid Pseudomonas aeruginosa (n = 200 strains), nonmucoid P. aeruginosa (n = 200), and Burkholderia cepacia complex (n = 200) isolated from patients with cystic fibrosis were 8 and 32, 8 and 64, and 8 and 32 μg/ml, respectively. Doripenem had somewhat better activity than established antimicrobial agents.

scholarly journals Epidemiology of first/new Pseudomonas aeruginosa infection in cystic fibrosis patients

2010 ◽  
Vol 9 ◽  
pp. S29 ◽  
Author(s):  
L. Zavataro ◽  
G. Taccetti ◽  
L. Cariani ◽  
N. Ravenni ◽  
G. Braccini ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Pseudomonas Aeruginosa Infection

scholarly journals In Vitro Newly Isolated Environmental Phage Activity against Biofilms Preformed by Pseudomonas aeruginosa from Patients with Cystic Fibrosis

2021 ◽  
Vol 9 (3) ◽  
pp. 478
Author(s):  
Ersilia Vita Fiscarelli ◽  
Martina Rossitto ◽  
Paola Rosati ◽  
Nour Essa ◽  
Valentina Crocetta ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Multidrug Resistant ◽  
In Vitro Test ◽  
Chronic Infections ◽  
Hospital Environments ◽  
Vitro Test ◽  
General Reliability ◽  
Phage Activity

As disease worsens in patients with cystic fibrosis (CF), Pseudomonas aeruginosa (PA) colonizes the lungs, causing pulmonary failure and mortality. Progressively, PA forms typical biofilms, and antibiotic treatments determine multidrug-resistant (MDR) PA strains. To advance new therapies against MDR PA, research has reappraised bacteriophages (phages), viruses naturally infecting bacteria. Because few in vitro studies have tested phages on CF PA biofilms, general reliability remains unclear. This study aimed to test in vitro newly isolated environmental phage activity against PA isolates from patients with CF at Bambino Gesù Children’s Hospital (OBG), Rome, Italy. After testing in vitro phage activities, we combined phages with amikacin, meropenem, and tobramycin against CF PA pre-formed biofilms. We also investigated new emerging morphotypes and bacterial regrowth. We obtained 22 newly isolated phages from various environments, including OBG. In about 94% of 32 CF PA isolates tested, these phages showed in vitro PA lysis. Despite poor efficacy against chronic CF PA, five selected-lytic-phages (Φ4_ZP1, Φ9_ZP2, Φ14_OBG, Φ17_OBG, and Φ19_OBG) showed wide host activity. The Φ4_ZP1-meropenem and Φ14_OBG-tobramycin combinations significantly reduced CF PA biofilms (p < 0.001). To advance potential combined phage-antibiotic therapy, we envisage further in vitro test combinations with newly isolated phages, including those from hospital environments, against CF PA biofilms from early and chronic infections.

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