Outcomes of adults with cystic fibrosis infected with antibiotic-resistant Pseudomonas aeruginosa
Outcomes of adults with cystic fibrosis infected with antibiotic-resistant Pseudomonas aeruginosa
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DOI：
10.1159/000087686
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发表时间：
2006-01-01
期刊：
影响因子：
3.7
通讯作者：
Boyle, MP
中科院分区：
文献类型：
--
作者：
Lechtzin, N;John, M;Boyle, MP
背景资料：虽然铜绿假单胞菌是囊性纤维化成人中最常见的细菌感染，并且经常对多种抗生素产生耐药性，但尚未确定多重耐药铜绿假单胞菌患者的临床结局是否比更敏感菌株的患者更差。目的：本研究评估了多重耐药铜绿假单胞菌对囊性纤维化成人肺功能、住院、抗生素使用、肺移植和生存率的影响。研究方法：在一项基于大学的成人囊性纤维化项目的队列研究中，对75名连续的成人囊性纤维化患者进行了为期4年的研究，这些患者从痰培养物中分离出铜绿假单胞菌。结果包括FEV 1下降、门诊就诊、住院、静脉抗生素疗程和天数以及肺移植。采用重复测量的多元线性回归和Poisson回归来评估结果。结果如下：与敏感菌株患者相比，耐药铜绿假单胞菌患者的基线肺部疾病更严重，FEV 1下降更快（160 ml/年，p = 0.003），接受肺移植的可能性显著更高（17.6 vs. 0%，p = 0.005）。结论：多重抗生素耐药铜绿假单胞菌感染与囊性纤维化的加速进展相关，并对感染控制策略，抗生素使用和肺移植具有重要意义。版权所有（C）2006 S. Karger AG，巴塞尔。
Background: Although Pseudomonas aeruginosa is the most common bacterial infection in adults with cystic fibrosis and frequently develops resistance to multiple classes of antibiotics, it has not been determined whether patients with multiple antibiotic-resistant Pseudomonas aeruginosa have worse clinical outcomes than patients with more susceptible strains. Objectives: This study assessed the impact of multiply-resistant P. aeruginosa on lung function, hospitalizations, antibiotic use, lung transplantation and survival in adults with cystic fibrosis. Methods: In a cohort study at a university-based adult cystic fibrosis program, 75 consecutive adult cystic fibrosis patients who had P. aeruginosa isolated from sputum cultures were studied over a 4-year period. Outcomes included decline in FEV1, clinic visits, hospitalizations, courses and days of intravenous antibiotics, and lung transplantation. Multiple linear and Poisson regression for repeated measures were used to assess the outcomes. Results: In comparison to patients with susceptible strains, patients with resistant P. aeruginosa had more severe baseline lung disease, more rapid decline in FEV1 (160 ml/year, p = 0.003) and were significantly more likely to undergo lung transplantation (17.6 vs. 0%, p = 0.005). Conclusions: Infection with multiple-antibiotic-resistant P. aeruginosa is associated with accelerated progression of cystic fibrosis, and has important implications for infection control strategies, antibiotic use and lung transplantation. Copyright (C) 2006 S. Karger AG, Basel.