Adult cystic fibrosis exacerbations and new strains of Pseudomonas aeruginosa

被引:91
|
作者
Aaron, SD
Ramotar, K
Ferris, W
Vandemheen, K
Saginur, R
Tullis, E
Haase, D
Kottachchi, D
St Denis, M
Chan, F
机构
[1] Univ Ottawa, Dept Med, Ottawa, ON K1N 6N5, Canada
[2] Univ Ottawa, Dept Pediat, Ottawa, ON K1N 6N5, Canada
[3] Ottawa Hlth Res Inst, Ottawa, ON, Canada
[4] Univ Toronto, Dept Med, Toronto, ON, Canada
[5] Dalhousie Univ, Dept Med, Halifax, NS B3H 3J5, Canada
关键词
cystic fibrosis; Pseudomonas aeruginosa; lung infection;
D O I
10.1164/rccm.200309-1306OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
We hypothesized that in adults with cystic fibrosis, the acquisition I of a new strain of Pseudomonas aeruginosa may be associated with a pulmonary exacerbation. Eighty-four patients who were chronically infected with A aeruginosa were prospectively followed from eight centers over a 26-month period. Patients had sputum cultures performed every 3 months while clinically stable and at the time of an exacerbation. Forty patients (48%) had an exacerbation requiring intravenous antibiotics during the study period, and in 36 of these patients, their P. aeruginoso isolates were genetically typeable by pulsed-field gel electrophoresis. In 34 of the 36 patients (94%), P. aeruginoso recovered during clinical stability and at exacerbation were of the same genotype. In only two patients (6%; 95% confidence interval, 0-18%) was a new P. aeruginosa clone cultured during an exacerbation that had not been cultured during clinical stability. There were no significant differences in antibiotic susceptibilities, measured as mean minimal inhibitory concentrations, for isolates retrieved during clinically stable periods compared with isolates retrieved during exacerbations. We conclude that for the majority of adult patients with cystic fibrosis a new pulmonary exacerbation is not caused by the acquisition of a new strain of P. aeruginosa.
引用
收藏
页码:811 / 815
页数:5
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