scholarly journals A Case of Phage Therapy against Pandrug-Resistant Achromobacter xylosoxidans in a 12-Year-Old Lung-Transplanted Cystic Fibrosis Patient

Viruses ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 60
Author(s):  
David Lebeaux ◽  
Maia Merabishvili ◽  
Eric Caudron ◽  
Damien Lannoy ◽  
Leen Van Simaey ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Cystic Fibrosis Patient ◽  
Phage Therapy ◽  
Lung Infection ◽  
Achromobacter Xylosoxidans ◽  
Resistant Bacteria ◽  
Low Grade ◽  
First Case ◽  
Phage Receptor ◽  
Airway Colonization

Bacteriophages are a promising therapeutic strategy among cystic fibrosis and lung-transplanted patients, considering the high frequency of colonization/infection caused by pandrug-resistant bacteria. However, little clinical data are available regarding the use of phages for infections with Achromobacter xylosoxidans. A 12-year-old lung-transplanted cystic fibrosis patient received two rounds of phage therapy because of persistent lung infection with pandrug-resistant A. xylosoxidans. Clinical tolerance was perfect, but initial bronchoalveolar lavage (BAL) still grew A. xylosoxidans. The patient’s respiratory condition slowly improved and oxygen therapy was stopped. Low-grade airway colonization by A. xylosoxidans persisted for months before samples turned negative. No re-colonisation occurred more than two years after phage therapy was performed and imipenem treatment was stopped. Whole genome sequencing indicated that the eight A. xylosoxidans isolates, collected during phage therapy, belonged to four delineated strains, whereby one had a stop mutation in a gene for a phage receptor. The dynamics of lung colonisation were documented by means of strain-specific qPCRs on different BALs. We report the first case of phage therapy for A. xylosoxidans lung infection in a lung-transplanted patient. The dynamics of airway colonization was more complex than deduced from bacterial culture, involving phage susceptible as well as phage resistant strains.

Phage therapy against Achromobacter xylosoxidans lung infection in a patient with cystic fibrosis: a case report

2018 ◽  
Vol 169 (9) ◽  
pp. 540-542 ◽  
Author(s):  
N. Hoyle ◽  
P. Zhvaniya ◽  
N. Balarjishvili ◽  
D. Bolkvadze ◽  
L. Nadareishvili ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Case Report ◽  
Phage Therapy ◽  
Lung Infection ◽  
Achromobacter Xylosoxidans

Chronic Lung Infection Caused by Trichosporon mycotoxinivorans and Trichosporon mucoides in an Immunocompetent Cystic Fibrosis Patient

2016 ◽  
Vol 52 (7) ◽  
pp. 400 ◽  
Author(s):  
Francisco de Borja Martínez Muñiz ◽  
María Martínez Redondo ◽  
Concepción Prados Sánchez ◽  
Julio García Rodríguez
Keyword(s):  
Cystic Fibrosis ◽  
Cystic Fibrosis Patient ◽  
Lung Infection ◽  
Chronic Lung Infection

Proteus mirabilis as a cause of recurrent lung infection in a cystic fibrosis patient

1990 ◽  
Vol 9 (3) ◽  
pp. 234-235 ◽  
Author(s):  
M. Ojeda-Vargas ◽  
A. Pacheco ◽  
M. Elia ◽  
R. Villaverde ◽  
F. Baquero
Keyword(s):  
Cystic Fibrosis ◽  
Cystic Fibrosis Patient ◽  
Proteus Mirabilis ◽  
Lung Infection

scholarly journals Chronic Airway Colonization byAchromobacter xylosoxidansin Cystic Fibrosis Patients Is Not Sustained by Their Domestic Environment

2018 ◽  
Vol 84 (23) ◽  
Author(s):  
Chloé Dupont ◽  
Estelle Jumas-Bilak ◽  
Clara Doisy ◽  
Fabien Aujoulat ◽  
Raphaël Chiron ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Tract ◽  
Antimicrobial Agents ◽  
Patient Specific ◽  
Achromobacter Xylosoxidans ◽  
Opportunistic Pathogens ◽  
Domestic Environment ◽  
Content Type ◽  
Domestic Environments ◽  
Airway Colonization

ABSTRACTAchromobacterspp. are nonfermentative Gram-negative bacilli considered emergent pathogens in cystic fibrosis (CF). Although some cross-transmission events between CF patients have been described,Achromobacterstrains were mostly patient specific, suggesting sporadic acquisitions from nonhuman reservoirs. However, sources of these emergent CF pathogens remain unknown. A large collection of specimens (n= 273) was sampled in the homes of 3 CF patients chronically colonized byAchromobacter xylosoxidanswith the aim of evaluating the potential role of domestic reservoirs in sustaining airway colonization of the patients. Samples were screened for the presence ofAchromobacterby using genus-specific molecular detection. Species identification, multilocus genotypes, and antimicrobial susceptibility patterns observed for environmental isolates were compared with those of clinical strains. Patient homes hosted a high diversity ofAchromobacterspecies (n= 7), includingAchromobacter mucicolensandA. animicus, two species previously isolated from human samples only, and genotypes (n= 15), all showing an overall susceptibility to antimicrobial agents.Achromobacterstrains were mostly isolated from indoor moist environments and siphons, which are potential reservoirs for several CF emerging pathogens.A. xylosoxidans, the worldwide prevalent species colonizing CF patients, was not the majorAchromobacterspecies inhabiting domestic environments.A. xylosoxidansgenotypes chronically colonizing the patients were not detected in their household environments. These results support the notions that the domestic environment could not be incriminated in sustained patient colonization and that after initial colonization, the environmental survival ofA. xylosoxidansclones adapted to the CF airways is probably impaired.IMPORTANCEAchromobacterspp. are worldwide emerging opportunistic pathogens in CF patients, able to chronically colonize the respiratory tract. Apart from regular consultations at the hospital CF center, patients spend most of their time at home. Colonization from nonhuman sources has been suggested, but the presence ofAchromobacterspp. in CF patients' homes has not been explored. The domestic environments of CF patients chronically colonized byAchromobacter, especially wet environments, host several opportunistic pathogens, including a large diversity ofAchromobacterspecies and genotypes. However,Achromobactergenotypes colonizing the patients were not detected in their domestic environments, making it unlikely that a shuttle between environment and CF airways is involved in persisting colonization. This also suggests that once the bacteria have adapted to the respiratory tract, their survival in the domestic environment is presumably impaired. Nevertheless, measures for reducing domestic patient exposure should be targeted on evacuation drains, which are frequently contaminated by CF opportunistic pathogens.

scholarly journals Cedecea davisae’s Role in a Polymicrobial Lung Infection in a Cystic Fibrosis Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Thayer G. Ismaael ◽  
Eleana M. Zamora ◽  
Faisal A. Khasawneh
Keyword(s):  
Cystic Fibrosis ◽  
Staphylococcus Aureus ◽  
Burkholderia Cepacia ◽  
Airway Disease ◽  
Lung Infection ◽  
Emerging Pathogen ◽  
The Family ◽  
Healthcare Associated ◽  
Airway Colonization

Chronic airway colonization and infection are the hallmark of cystic fibrosis (CF).Staphylococcus aureus, Pseudomonas aeruginosa, andBurkholderia cepaciaare well-documented bacterial culprits in this chronic suppurative airway disease. Advanced molecular diagnostics have uncovered a possible role of a larger group of microorganisms in CF.Cedeceais a member of the family Enterobacteriaceae and is an emerging pathogen. We present a case of a polymicrobial healthcare-associated pneumonia in a CF patient caused byCedecea davisae, among other bacteria.

Arthropathy Secondary to Ciprofloxacin in an Adult Cystic Fibrosis Patient

1993 ◽  
Vol 27 (3) ◽  
pp. 302-303 ◽  
Author(s):  
Wayne M. Samuelson ◽  
Roy A. Pleasants ◽  
Martha S. Whitaker
Keyword(s):  
Cystic Fibrosis ◽  
Adult Patient ◽  
Cystic Fibrosis Patient ◽  
Pediatric Patients ◽  
Prior History ◽  
Case Summary ◽  
First Case ◽  
Acute Exacerbations ◽  
History Of ◽  
Possible Cause

OBJECTIVE: To report a case of possible ciprofloxacin-induced arthropathy in an adult patient with cystic fibrosis (CF). CASE SUMMARY: A 25-year-old man with CF received three separate courses of ciprofloxacin therapy at usual doses for acute pulmonary exacerbations of his disease. During the second and third courses, the patient experienced bilateral swelling of his knees between two to three weeks after initiation of each course. Both times symptoms markedly decreased after discontinuation of the drug. The patient had no prior history of arthropathy. Furthermore, during the last two acute exacerbations of his CF, he did not receive ciprofloxacin and did not experience any symptoms of arthropathy. DISCUSSION: Prior cases of quinolone-induced arthropathy involving pediatric CF patients or adult patients without CF have been reported in the literature. We report the first case of such an arthropathy in an adult patient with CF. The findings are supported by a rechallenge with the drug. CONCLUSIONS: It is likely that ciprofloxacin may produce arthropathy in adult as well as pediatric patients with CF. Quinolones should be considered as a possible cause of arthropathy in adult CF patients.

scholarly journals Relapse of chronic melioidosis in a paediatric cystic fibrosis patient: first case report from Malaysia

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Vanitha Mariappan ◽  
Surendran Thavagnanam ◽  
Kumutha Malar Vellasamy ◽  
Cindy Ju Shuan Teh ◽  
Nadia Atiya ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Case Report ◽  
Cystic Fibrosis Patient ◽  
First Case

Unorthodox long-term aerosolized ampicillin use for methicillin-susceptible Staphylococcus aureus lung infection in a cystic fibrosis patient

2009 ◽  
Vol 44 (5) ◽  
pp. 512-515 ◽  
Author(s):  
Luis Máiz ◽  
Adelaida Lamas ◽  
Ana Fernández-Olmos ◽  
Lucrecia Suárez ◽  
Rafael Cantón
Keyword(s):  
Cystic Fibrosis ◽  
Staphylococcus Aureus ◽  
Cystic Fibrosis Patient ◽  
Lung Infection

scholarly journals Longitudinal monitoring of sinonasal and oral bacterial reservoirs to prevent chronic lung infection in people with cystic fibrosis

2020 ◽  
Vol 6 (3) ◽  
pp. 00115-2020 ◽  
Author(s):  
Rebeca Passarelli Mantovani ◽  
Angela Sandri ◽  
Marzia Boaretti ◽  
Gloria Burlacchini ◽  
Veronica Li Vigni ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Bacterial Species ◽  
Initial Period ◽  
Lung Infection ◽  
Abundant Species ◽  
Nasal Lavage ◽  
Lower Airway ◽  
Achromobacter Xylosoxidans ◽  
Clonal Identity ◽  
Almost All

BackgroundParanasal sinuses act as bacterial reservoirs and contribute to transmitting bacteria to the lower airway of patients with cystic fibrosis (CF). Also, passage of bacteria from the oral cavity to the lungs may occur.MethodsWe evaluated the presence of Pseudomonas aeruginosa, Staphylococcus aureus, Stenotrophomonas maltophilia, Achromobacter xylosoxidans and Serratia marcescens in sputum and nasal lavage of 59 patients with CF, and also collected saliva and used toothbrushes from 38 of them. We assessed the clonal identity of the strains isolated from the different samples by pulsed-field gel electrophoresis.ResultsAbout 80% of the patients were positive for at least one of the bacterial species examined in nasal lavage and sputum. Among the subjects with positive sputum, 74% presented the same species in the nasal lavage and saliva, and 26% on their toothbrush. S. aureus was the most abundant species in all samples. Clonal identity (≥80% similarity) of the strains isolated among the different samples from each patient was confirmed in almost all cases. Longitudinal observation helped to identify five patients who were colonised in the lower airways after an initial period of nasal or oral colonisation.ConclusionNasal and oral sites act as bacterial reservoirs, favouring the transmission of potentially pathogenic microorganisms to the lower airway. The lack of eradication from these sites might undermine the antibiotic therapy applied to treat the lung infection, allowing the persistence of the bacteria within the patient if colonisation of these sites is not assessed, and no specific therapy is performed.

scholarly journals 730. Cefiderocol for the Treatment of Achromobacter xylosoxidans Infections in Two Lung Transplant Patients with Cystic Fibrosis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S326-S327 ◽  
Author(s):  
Nathaniel C Warner ◽  
Luther Bartelt ◽  
Anne Lachiewicz ◽  
Anne Lachiewicz ◽  
Kathleen Marie Tompkins ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Transplant ◽  
Achromobacter Xylosoxidans ◽  
Transplant Recipients ◽  
Compassionate Use ◽  
Chronic Infections ◽  
Gram Negative ◽  
First Case ◽  
Lung Transplant Recipients

Abstract Background Achromobacter xylosoxidansis a highly resistant Gram-negative bacterium that causes chronic infections in patients with cystic fibrosis (CF). Treatment options for A. xylosoxidans are limited. In the peri-lung transplant setting, the treatment of A. xylosoxidans infections is especially challenging. Cefiderocol is a novel siderophore cephalosporin antibiotic with broad anti-Gram-negative activity, including against A. xylosoxidans. We report here two cases of compassionate use of cefiderocol in CF lung transplant recipients with A. xylosoxidans infection. Methods Cefiderocol was obtained through compassionate use from its manufacturer, with approval from the local Institutional Review Board. In the first case, it was used as salvage treatment, and in the second case as a planned part of the peri-transplant regimen. Results A male in his 20s with CF and a trimethoprim-sulfamethoxazole (TMP-SMX) allergy was chronically colonized by A. xylosoxidans, which was sensitive only to piperacillin–tazobactam (PIP-TAZ), and TMP-SMX. After lung transplant, he developed A. xylosoxidansbacteremia, and extended-infusion PIP-TAZ was started. Repeat bronchoscopy grew A. xylosoxidans. Due to lack of improvement, cefiderocol was added to PIP-TAZ with rapid clinical improvement. However, after completing his course, he was readmitted with A. xylosoxidans pneumonia. He was treated with 6 weeks of cefiderocol and imipenem and has been well since with an 8-month follow-up. In the second case, cefiderocol was used as part of the planned peri-transplant regimen for a female with CF in her late teens, with chronic A. xylosoxidans colonization, which was intermediate to PIP-TAZ, and resistant to all other drugs tested. Her native lungs grew 4+ A. xylosoxidans at the time of explant. Post-transplant, she was treated with 5 weeks of meropenem and 6 weeks of cefiderocol. At four-month follow-up, she is doing well. However, she is asymptomatically colonized with A. xylosoxidanspost-transplant. Isolates from both cases were susceptible to cefiderocol (case #1 MIC = 0.12; case #2 pretreatment MIC = 1, post-treatment MIC. Conclusion Cefiderocol may be a useful option for lung transplant recipients with A. xylosoxidans infections. Disclosures Anne Lachiewicz, MD, MPH, MicroGenDx: Consultant; Shionogi: Consultant.

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