Bacteraemia and fungaemia in adults with cystic fibrosis

Fahy, J.V.; Keoghan, M; Crummy, E.J.; FitzGerald, M. X.

doi:10.1016/s0163-4453(05)80005-2

Cited by 25 publications

(22 citation statements)

References 9 publications

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“…A high incidence of fungal septicaemia (66% in this study) occurs among CF patients [17,18]. Whether or not CF patients with TIVADs should receive daily antifungal prophylaxis is controversial [8,18,19].…”

Section: Discussionmentioning

confidence: 74%

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

Munck

Malbezin²,

Bloch³

et al. 2004

Eur Respir J

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The use and complications of totally implantable vascular access devices (TIVADs) were examined during multiple courses of antibiotics in cystic fibrosis (CF) patients.This retrospective study involved 36 CF centres. Risk factors for removal and septicaemia were sought by survival analysis of censored data. Multivariate Cox models were constructed with removal or septicaemia as the event and the characteristics of TIVADs as explanatory variables.TIVADs (n=452) were implanted in 315 patients. The mean functional time per device was 32¡25 months. Long-term complications occurred with 188 devices (42%); they consisted mainly of occlusion (21%, requiring removal in 77%), infection (9.3%, requiring removal in 85%; septicaemia in 7.3%; rate 0.3 per 1,000 days, Candida in 66%), and vascular thrombosis (4.7%, removal in 58%). Multivariate survival analysis showed that removal, whatever the reason, was associated with polyurethane (versus silicone) and routine use of the device for blood sampling (versus never). No risk factors, including heparin lock, were identified for septicaemia or for removal for obstruction.Totally implantable venous access devices appear to be safe and reliable for longterm intermittent venous access. Although retrospective, this study suggests that the characteristics of the material and blood sampling are risk factors for removal. Chronic infections in patients with cystic fibrosis (CF), especially after colonisation by Pseudomonas aeruginosa, require repeated courses of intravenous antibiotics. Increasing problems with peripheral venous access may indicate implantation of a central venous access.Relative to external central catheters, totally implantable vascular access devices (TIVADs) facilitate long-term maintenance, permit almost unlimited physical activity, and improve the patient9s self-image, which is especially important for children and young adults. Nevertheless, TIVADs are associated with a number of complications. Previous studies of these devices in CF patients have involved small groups. The experience of 36 CF centres over a period of 9 yrs is reported here, based on systematic review of the implantation procedure, use, long-term maintenance and complications. Materials and methods PatientsThe medical charts of 315 CF patients who underwent one or more TIVAD procedures between January 1990 and December 1998 were reviewed. The patients were treated in 36 CF centres. A chart was sent to a corresponding physician in each CF centre who collected the data for all the patients treated in their centre. Data analysed included patient age, P. aeruginosa colonisation, surgical reports (TIVAD model, insertion site, procedure, prophylactic antibiotics, immediate complications), TIVAD use (courses of antibiotics, parenteral nutrition, lipid infusion, blood sampling), long-term maintenance (heparin, physiological sera, counter-pressure), longterm complications (catheter occlusion, vascular thrombosis, infection, discomfort, catheter rupture, displacement or disconnection, aestheti...

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Section: Discussionmentioning

confidence: 74%

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

Munck

Malbezin²,

Bloch³

et al. 2004

Eur Respir J

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“…Nearly all patients with cystic fibrosis develop chronic pulmonary infections with P. aeruginosa. [34][35][36][37] Because these patients have normal immune defenses, the Pseudomonas exists in well-established biofilms, and Pseudomonas bacteremia is extremely rare. [34][35][36][37] In contrast, when this organism colonizes the compromised patient (e.g., burn, neutropenic, cancer, or transplant patients), a severe, even overwhelming, infection can occur.…”

Section: Discussionmentioning

confidence: 99%

“…[34][35][36][37] Because these patients have normal immune defenses, the Pseudomonas exists in well-established biofilms, and Pseudomonas bacteremia is extremely rare. [34][35][36][37] In contrast, when this organism colonizes the compromised patient (e.g., burn, neutropenic, cancer, or transplant patients), a severe, even overwhelming, infection can occur. 34,37 In this study, we found an association between quantitative bacterial slime production and the subsequent development of bactibilia, bacteremia, and the severity of the associated illness.…”

Section: Discussionmentioning

confidence: 99%

Gallstones Containing Bacteria are Biofilms: Bacterial Slime Production and Ability to Form Pigment Solids Determines Infection Severity and Bacteremia

Stewart

Griffiss

Jarvis

et al. 2007

Journal of Gastrointestinal Surgery

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Bacteria-laden gallstones are biofilms whose characteristics influence illness severity. Factors creating colonization surface (beta-glucuronidase/phospholipase) facilitated bacteremia and severe infections; but abundant slime production, while facilitating colonization, inhibited detachment and cholangiovenous reflux. This shows how properties of the gallstone biofilm determine the severity of the associated illness.

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“…In addition, the fungal community may be more diverse than culturing results have shown. Depending on the organism present, fungal infections can lead to health problems ranging from allergic bronchopulmonary aspergillosis (ABPA) to post-transplant fungaemia (Fahy et al, 1991;Kubak, 2002;Mastella et al, 2000;Nagano et al, 2007) It is also possible for a fungal infection to become chronic and lead to bronchitis (Nagano et al, 2007). 8…”

Section: Hypervariable Region 1 V1mentioning

confidence: 99%

“…In another study, 24.5 % of 201 patients were culture positive for A. fumigatus (Burns et al, 1998). Detection of fungal infections is crucial as the infection can lead to complications such as allergic bronchopulmonary aspergillosis (ABPA) and post-transplant fungaemia (Fahy et al, 1991;Kubak, 2002;Mastella et al, 2000;Nagano et al, 2007;Stevens et al, 2003) It is also possible for a fungal infection to become chronic which leads to bronchitis (Nagano et al, 2007).…”

Section: Acknowledgementsmentioning

confidence: 99%

A Multi-Faceted Diagnostic Approach to Lung Infections in Patients with Cystic Fibrosis

Doud¹

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Bacteraemia and fungaemia in adults with cystic fibrosis

Cited by 25 publications

References 9 publications

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

Gallstones Containing Bacteria are Biofilms: Bacterial Slime Production and Ability to Form Pigment Solids Determines Infection Severity and Bacteremia

A Multi-Faceted Diagnostic Approach to Lung Infections in Patients with Cystic Fibrosis

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