Transmissibility of Pseudomonas cepacia infection in clinic patients and lung-transplant recipients with cystic fibrosis.
Transmissibility of Pseudomonas cepacia infection in clinic patients and lung-transplant recipients with cystic fibrosis.
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洋葱假单胞菌感染在临床患者和囊性纤维化肺移植受者中的传播性。
DOI：
10.1056/nejm199410133311504
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Goldstein,R
中科院分区：
文献类型：
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作者：
Steinbach,S;Sun,L;Jiang,RZ;Flume,P;Gilligan,P;Egan,TM;Goldstein,R
背景在囊性纤维化患者中，洋葱假单胞菌感染与不良预后相关。然而，人与人之间传播的程度和肺移植后洋葱伯克霍尔德菌感染的来源还没有很好的定义。使用DNA为基础的分型系统，我们试图确定的遗传相关性的洋葱丙酸杆菌感染在一个囊性fibrosis center.MethodsWe分析了65个洋葱丙酸杆菌菌株收集在一个为期8年的一个单一的囊性纤维化中心从17个临床患者和5例患者进行双肺移植。的菌株进行了分析，核糖体分型和染色体指纹图谱的基础上pulsed-field gel electrophoresis.ResultsAnalyses的系列分离株显示，每个临床病人和移植受体窝藏不同的洋葱疫霉克隆是持久的。在移植受者中，术前和术后分离株相同。在肺移植后播散性感染的2例患者中，来自多个部位的分离株相同，表明先前呼吸道洋葱假单胞菌菌株的克隆扩增。脉冲场凝胶电泳被证明是更具歧视性和更实用的核糖分型作为一种手段，定义的遗传相关性的洋葱疫霉isolates.ConclusionsOur系列分析在一个中心的囊性纤维化患者发现不同的菌株洋葱疫霉持续感染每个病人，没有证据表明人与人之间的传播这种有机体。肺移植后洋葱伯克霍尔德菌感染是由于移植前存在的菌株持续存在。
BackgroundIn patients with cystic fibrosis, infection with Pseudomonas cepacia is associated with poor outcomes. However, the extent of person-to-person transmission and the source of P. cepacia infection after lung transplantation are not well defined. Using DNA-based typing systems, we sought to determine the genetic relatedness of P. cepacia infection at one cystic fibrosis center.MethodsWe analyzed 65 P. cepacia isolates gathered over a period of eight years at a single cystic fibrosis center from 17 clinic patients and from 5 patients who underwent double-lung transplantation. The isolates were analyzed by ribotyping and chromosomal fingerprinting based on pulsed-field gel electrophoresis.ResultsAnalyses of serial isolates revealed that each clinic patient and transplant recipient harbored a different P. cepacia clone that was persistent. In the transplant recipients, the preoperative and postoperative isolates were identical. In the two patients with disseminated infection after lung transplantation, isolates from multiple sites were identical and indicated clonal expansion of the previous respiratory P. cepacia strain. Pulsed-field gel electrophoresis proved both more discriminative and more practical than ribotyping as a means of defining the genetic relatedness of the P. cepacia isolates.ConclusionsOur serial analyses in patients with cystic fibrosis at one center found distinct strains of P. cepacia persistently infecting each patient and no evidence of person-to-person transmission of this organism. P. cepacia infection after lung transplantation was due to the persistence of the strain present before transplantation.