carter-pseudomonasaeruginosa-2015.pdf (1.19 MB)
Pseudomonas aeruginosa genotypes acquired by children with cystic fibrosis by age 5-years.
journal contribution
posted on 2015-05-01, 00:00 authored by T J Kidd, K A Ramsay, S Vidmar, J B Carlin, S C Bell, C E Wainwright, K Grimwood, P W Francis, C Dakin, J Cheney, N George, C F Robertson, Marj MoodieMarj Moodie, R Carzino, Rob CarterRob Carter, B Whitehead, J Hunter, C A Byrnes, H A Tiddens, K Graniel, K Gerbrands, L MottBACKGROUND: We describe Pseudomonas aeruginosa acquisitions in children with cystic fibrosis (CF) aged ≤5-years, eradication treatment efficacy, and genotypic relationships between upper and lower airway isolates and strains from non-CF sources. METHODS: Of 168 CF children aged ≤5-years in a bronchoalveolar lavage (BAL)-directed therapy trial, 155 had detailed microbiological results. Overall, 201/271 (74%) P. aeruginosa isolates from BAL and oropharyngeal cultures were available for genotyping, including those collected before and after eradication therapy. RESULTS: Eighty-two (53%) subjects acquired P. aeruginosa, of which most were unique strains. Initial eradication success rate was 90%, but 36 (44%) reacquired P. aeruginosa, with genotypic substitutions more common in BAL (12/14) than oropharyngeal (3/11) cultures. Moreover, oropharyngeal cultures did not predict BAL genotypes reliably. CONCLUSIONS: CF children acquire environmental P. aeruginosa strains frequently. However, discordance between BAL and oropharyngeal strains raises questions over upper airway reservoirs and how to best determine eradication in non-expectorating children.
History
Journal
Journal of cystic fibrosisVolume
14Issue
3Pagination
361 - 369Publisher
ElsevierLocation
Amsterdam, The NetherlandsPublisher DOI
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eISSN
1873-5010Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2015, ElsevierUsage metrics
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Cystic fibrosisEradicationGenotypingInfectionPseudomonas aeruginosaAnti-Bacterial AgentsBronchoalveolar Lavage FluidChild, PreschoolDNA, BacterialFemaleFollow-Up StudiesGenotypeHumansInfantMaleOropharynxPseudomonas InfectionsRetrospective StudiesScience & TechnologyLife Sciences & BiomedicineRespiratory SystemLAVAGE-DIRECTED THERAPYCHRONIC LUNG INFECTIONYOUNG-CHILDRENBRONCHOALVEOLAR LAVAGEOROPHARYNGEAL CULTURESERADICATION THERAPYDIAGNOSTIC-TOOLSTRAINSINFANTSCOLONIZATIONACFBAL Study Investigators
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