Microbiology of airway disease in a cohort of patients with Cystic Fibrosis
Microbiology of airway disease in a cohort of patients with Cystic Fibrosis
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DOI：
10.1186/1471-2334-6-4
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发表时间：
2006-01-11
影响因子：
3.7
通讯作者：
Rossano, F
中科院分区：
文献类型：
--
作者：
Lambiase, A;Raia, V;Rossano, F
背景资料：最近的报道记录了新的革兰氏阴性病原体如从囊性纤维化患者中分离的嗜麦芽窄食单胞菌和木糖氧化产碱杆菌的发病率增加，沿着常见革兰氏阴性病原体如铜绿假单胞菌和洋葱伯克霍尔德氏菌复合体的增加。此外，这些生物体的多药耐药性的增加使得这些患者的治疗管理更成问题。因此，仔细的分离和鉴定，以及对抗生素敏感性的准确研究对于预测菌株的传播，改进治疗措施以及促进我们对新出现的病原体的流行病学的理解至关重要。本研究的第一个目的是确定的发病率和患病率的革兰氏阴性菌从囊性纤维化患者的呼吸道样本中分离出的区域转介囊性纤维化中心Naples的定植;第二个是评估这些organis.Methods的多重耐药谱：参加区域囊性纤维化单位的患者（n = 300）在这项研究中招募了3年以上。处理痰液进行显微镜检查和培养。使用自动化系统Phoenix（Becton Dickinson，Sparks，马里兰州，美国）对所有菌株进行表型鉴定;当Phoenix系统鉴定不准确时，使用API 20 NE鉴定系统（bioMerieux，Marcy l 'Etoile，法国）。PCR-RFLP方法用于表征洋葱伯克霍尔德菌复合体中的微生物。采用微量肉汤稀释液（Phoenix）进行药敏试验。结果：铜绿假单胞菌、洋葱伯克霍尔德菌、嗜麦芽窄食单胞菌和木糖氧化产碱杆菌的感染率分别为40%、7%、11%和7%。在分离出的菌株中，460株具有多重耐药性。多重耐药的铜绿假单胞菌和洋葱伯克霍尔德菌complex.Conclusion：结果证实了以前报道的数据，特别是，他们显示了一个增加的非发酵革兰氏阴性菌的囊性纤维化患者的隔离。它们还表现出对抗生素的耐药性增加。β-内酰胺类药物很少有效，但头孢他啶除外，它是对抗多重耐药菌株最有效的药物。氨基糖苷类和喹诺酮类药物疗效较差。
Background: Recent reports document an increasing incidence of new Gram-negative pathogens such as Stenotrophomonas maltophilia and Alcaligenes xylosoxidans isolated from patients with Cystic Fibrosis, along with an increase in common Gram-negative pathogens such as Pseudomonas aeruginosa and Burkholderia cepacia complex. Furthermore, the increase in multidrug-resistance of such organisms makes the therapeutic management of these patients more problematic. Therefore, careful isolation and identification, and accurate studies of susceptibility to antibiotics are critical for predicting the spread of strains, improving therapeutic measures and facilitating our understanding of the epidemiology of emerging pathogens. The first aim of this study was to determine the incidence and the prevalence of colonization by Gram-negative organisms isolated from respiratory samples of Cystic Fibrosis patients in the Regional Referral Cystic Fibrosis Centre of Naples; the second was to evaluate the spectrum of multidrug-resistance of these organisms.Methods: Patients ( n = 300) attending the Regional Cystic Fibrosis Unit were enrolled in this study over 3 years. Sputum was processed for microscopic tests and culture. An automated system, Phoenix (Becton Dickinson, Sparks, Maryland, USA), was used for phenotypic identification of all strains; the API 20 NE identification system (bioMerieux, Marcy l'Etoile, France) was used when the identification with the Phoenix system was inaccurate. A PCR-RFLP method was used to characterize the organisms in the Burkholderia cepacia complex. A chemosusceptibility test on microbroth dilutions ( Phoenix) was used. Primary outcomes such as FEV1 were correlate with different pathogens.Results: During the period of study, 40% of patients was infected by Pseudomonas aeruginosa, 7% by Burkholderia cepacia complex, 11% by Stenotrophomonas maltophilia and 7% by Alcaligenes xylosoxidans. Of the strains isolated, 460 were multidrug-resistant. Multiresistant were Pseudomonas aeruginosa and Burkholderia cepacia complex.Conclusion: The results confirm previously reported data; in particular, they show an increase the isolation of non-fermentative Gram-negative bacteria in Cystic Fibrosis patients. They also demonstrate increased resistance to antibiotics. Beta-lactams are rarely effective, with exception of ceftazidime, which is the most efficacious agent against multiresistant strains. Aminoglycosides and quinolones are poorly efficacious.