Diagnóstico microbiológico de la colonización-infección broncopulmonar en el paciente con fibrosis quística

Abstract

Cystic fibrosis (CF), a condition produced by mutations in the gene that encodes the cystic fibrosis transmembrane conductance regulator, is the most prevalent autosomal-recessive hereditary disease in caucasian populations. Among other repercussions, this defect leads to an alteration of respiratory secretions and determines a predisposition for chronic bronchopulmonary colonization-infection, which is the main driver of the high morbidity and early mortality of CF patients. Colonization by Staphylococcus aureus and Haemophilus influenzae is frequent in children younger than 10 years, but mucoid Pseudomonas aeruginosa is by far the most relevant pathogen in adults with CF and is responsible for the progressive bronchopulmonary deterioration. As a consequence of repeated, long-lasting antimicrobial treatments and deterioration of lung function, colonization by multidrug-resistant Gram-negative bacilli, such as Stenotrophomonas maltophilia, Achromobacter spp. and Burkholderia cepacia complex, is also frequent in adult CF patients. The special characteristics of the pathologic process and the microorganisms implicated in CF make it advisable to consider microbiological follow-up of chronic bronchopulmonary colonization-infection in these patients a specific diagnostic entity.

Individual Patterns of Complexity in Cystic Fibrosis Lung Microbiota, Including Predator Bacteria, over a 1-Year Period

“…Sputum samples were routinely aerobically cultured in accordance with the recommendations of the Spanish CF guidelines ( 65 ). Briefly, after homogenization with N -acetyl- l -cysteine and/or sterile saline solution, the samples were qualitatively and quantitatively used to seed (10 −2 and 10 −4 dilutions) general media (Columbia agar with sheep blood and with chocolate horse blood) and selective/differential media (MacConkey agar, B. cepacia selective agar, mannitol-salt agar, bacitracin chocolate agar, and Sabouraud chloramphenicol agar).…”

Pandoraea pnomenusa Superinfection in a Patient with SARS-CoV-2 Pneumonia: First Case in the Literature

“…Regarding microbiological identification, initially, we used chocolate agar, which showed typical colonies (circular, grayish, and opaque), incubated aerobically at 37 °C for 48 h (two to three days are required for this microorganism to grow in a selective medium) [ 11 ]. Since phenotypic identification is not reliable, molecular techniques were applied using MALDI-TOF MS with the Microflex LT mass spectrometer with the FlexControl 3.0 and MALDI BioTyper 2.0 and 3.0 software programs, identifying the isolate as P. pnomenusa with values indicating secure genus identification and probable species identification.…”

Consenso español para la prevención y el tratamiento de la infección bronquial por Pseudomonas aeruginosa en el paciente con fibrosis quística

“…En 2005, el Grupo Español de Consenso del Tratamiento Antimicrobiano en el Paciente con Fibrosis Quística publicó un documento sobre el tratamiento antimicrobiano de la infección pulmonar por P. aeruginosa en estos pacientes 1 que fue pionero al considerar los aspectos farmacocinéticos (PK) y farmacodinámicos (PD) del tratamiento y la dinámica de la infección bacteriana en la FQ. La publicación de otras recomendaciones [2][3][4][5][6] , el cribado neonatal 7 , la autorización de nuevos antibióticos en FQ 8,9 y el avance del conocimiento [10][11][12][13][14][15][16][17][18][19] hacen necesaria su actualización. Las recomendaciones se han establecido en grados de evidencia 20 a partir de estudios incluidos en PubMed y ponderado según la experiencia clínica (tabla 1).…”