Genotyping ofPseudomonas aeruginosasputum and stool isolates from cystic fibrosis patients: evidence for intestinal colonization and spreading into toilets

Abstract

Three hundred and fifty-eight stool and 131 sputum specimens from 40 cystic fibrosis (CF) patients and 100 toilet sinks were investigated for occurrence of Pseudomonas aeruginosa; 67% (21/31) of the patients with chronic P. aeruginosa lung infections carried the organism repeatedly in the stool but the organism was found only once in the stools of nine uninfected patients. P. aeruginosa stool carriage was correlated to high P. aeruginosa numbers in patients' sputa. Typing of P. aeruginosa with a DNA probe showed identity of sputum and stool strains. Seven patients repeatedly carried additional stool strains, not found in the sputum, suggesting intestinal colonization. No differences were seen in the clinical state of patients with P. aeruginosa-negative stool samples and patients with positive stool samples. Toilets in households of P. aeruginosa-infected CF patients were significantly more often contaminated with P. aeruginosa (42%) than toilets in households of non-infected CF patients (20%; P less than 0.03). The study shows that P. aeruginosa-infected CF patients may harbour the organisms also in the intestinal tract, and may spread the bacteria into toilets.

Prospects for the Prevention and Control of Pseudomonal Infection in Children with Cystic Fibrosis

“…[34] This bacteria is rarely found in the stools of healthy humans and, even then, only in small numbers. [35][36][37][38] This opportunistic pathogen colonises patients with compromised defence mechanisms. It is inherently resistant to many antibiotics and has become an important hospital pathogen causing cross-infections.…”

Complexity ofPseudomonas aeruginosainfection in cystic fibrosis: combined results from esterase electrophoresis and rDNA restriction fragment length polymorphism analysis

“…These two methods have already been shown individually to be powerful and readily applicable epidemiological tools [9,11,19,[24][25][26][27][28][29][30]. RFLPs in the exotoxin A [3][4][5][6][7] or pilin [4,5,8] gene regions have also been used successfully as specific genetic markers to differentiate P. aeruginosa strains. However, one advantage we see in our approach is that, as with genomic fingerprinting by FIGE [2], it is comprehensively applicable to other bacterial species.…”

“…Recently. genome fingerprinting by field inversion gel electrophoresis (FIGE) [2] and restriction fragment length polymorphism (RFLP) in the exotoxin A [3][4][5][6][7] or pilin gene regions [4,5,8] have been used as molecular approaches to P. aeruginosa epidemiology in CF. Esterase electrophoretic typing [9][10][11] and RFLP of rDNA regions [10] have been shown to provide discriminative data for epidemiological screening in non-CF patients' P. aeruginosa strains.…”

Gut dysbiosis in cystic fibrosis

“…In people with CF, intestinal exocrine malfunction, antibiotic usage [1] and swallowing of infected respiratory mucus [2] likely perturb the normal community of commensal bacteria in the gut. People with CF report various intestinal problems which may be alleviated by probiotic administration [3].…”