Clinical application of direct sputum sensitivity testing in a severe infective exacerbation of cystic fibrosis

Abstract

A 16-year-old male with cystic fibrosis (CF) was admitted to hospital with a severe infective exacerbation. Despite standard management, including conventionally selected intravenous antibiotics for Pseudomonas aeruginosa, chest physiotherapy, and institution of noninvasive ventilation (NIV) for progressive hypercapneic respiratory failure, he continued to deteriorate. Direct sputum sensitivity testing (DSST) revealed a novel combination of antibiotics that resulted in a rapid and remarkable clinical improvement. DSST is a form of "whole" sputum sensitivity testing that provides information on antibiotic synergy, and may more accurately reflect in vivo antibiotic sensitivity patterns in cystic fibrosis.

Predicting the re-distribution of antibiotic molecules caused by inter-species interactions in microbial communities

“…My theory reconciles the unexpected observations found in direct sensitivity tests (5,9,26)-drug sensitivity tests that skip isolation and purification of the pathogenic agent (27)(28)(29). Using direct testing, pathogens known to be sensitive to a drug can be interpreted as resistant and vice versa (9,30).…”

Outcomes and endpoints reported in studies of pulmonary exacerbations in people with cystic fibrosis: A systematic review

“…The impact of treatment of a pulmonary exacerbation has also been captured as the change in a generic or disease-specific QoL score during therapy; such as scores generated from responses to the CF Questionnaire C-reactive protein (CRP) and white cell count were the most commonly reported biomarkers of inflammation [14,32,38,45,48,63,66,83,[99][100][101][102].…”