Early aggressive eradication therapy for intermittent Pseudomonas aeruginosa airway colonization in cystic fibrosis patients: 15 years experience
Early aggressive eradication therapy for intermittent Pseudomonas aeruginosa airway colonization in cystic fibrosis patients: 15 years experience
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DOI：
10.1016/j.jcf.2008.06.009
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发表时间：
2008-11-01
影响因子：
5.2
通讯作者：
Hoiby, N.
中科院分区：
文献类型：
--
作者：
Hansen, C. R.;Pressler, T.;Hoiby, N.
背景：自 1989 年以来，哥本哈根 CF 中心对间歇性铜绿假单胞菌定植的 CF 患者采用吸入粘菌素和口服环丙沙星进行治疗。该研究评估了这种治疗方法 15 年的结果。方法：从 1989 年至 2003 年间断地被铜绿假单胞菌定植的 CF 患者中分离出的所有铜绿假单胞菌均被鉴定为抗铜绿假单胞菌。对铜绿假单胞菌治疗的使用抗生素、治疗持续时间、无假单胞菌间隔和慢性感染的发展进行了评估。对所有铜绿假单胞菌分离株进行耐药性和非粘液或粘液表型评估。结果：本研究纳入了 146 名 CF 患者（1106 患者年）。 99 名患者在研究期间首次被隔离。中位观察时间为 7 年 (0.1-14.9)。 12名患者出现慢性感染。 Kaplan Meyer 图显示，该药物可保护高达 80% 的患者免受慢性感染，持续时间长达 15 年。接受了 613 次粘菌素/环丙沙星治疗。与 3 周（5 个月）和 3 个月（10.4 个月）的粘菌素和环丙沙星相比，假性间隔没有差异，但与不治疗（1.9 个月）相比有显着差异。与仍间歇性定植的患者相比，发生慢性感染的患者在首次分离株治疗后的无假单胞菌间隔时间显着缩短（p
Background: Since 1989, CF-patients intermittently colonized with Pseudomonas aeruginosa have been treated with inhaled colistin and oral ciprofloxacin in the Copenhagen CF-centre. The study evaluates 15 years results of this treatment.Methods: All isolates of P aeruginosa from CF-patients intermittently colonized with P. aeruginosa from 1989 to 2003 were identified All antiP. aeruginosa treatments were evaluated for antibiotics used, treatment duration, pseudomonas-free interval and development of chronic infection. All P. aeruginosa isolates were assessed for resistance and for non-mucoid or mucoid phenotype.Results: 146 CF-patients were included in the study (1106 patient-years). 99 patients had first ever isolate during the study period. Median observation time 7 years (0.1-14.9). 12 patients developed chronic infection. A Kaplan Meyer plot showed protection from chronic infection in up to 80% of patients for up to 15 years. 613 colistin/ciprofloxacin treatments were given. There was no difference in pseudo in on as-free interval comparing 3 weeks (5 months) and 3 months (10.4 months) of colistin and ciprofloxacin, but a significant difference compared to no treatment (1.9 months). Patients developing chronic infection had significantly shorter pseudo monas-free interval after treatment of first ever isolate compared to patients remaining intermittently colonized (p