Microbial pathogenesis in cystic fibrosis: mucoid Pseudomonas aeruginosa and Burkholderia cepacia.

Govan, John R. W.; Deretić, Vojo

doi:10.1128/mmbr.60.3.539-574.1996

Cited by 1,234 publications

(839 citation statements)

References 394 publications

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“…The female patients also had significantly higher prevalence of chronic Burkholderia infection, an infection closely related to high morbidity and mortality. 22,23 We found no significant difference in age or frequency at CFRD diagnosis, even if the median age of diabetic patients was 3 years lower in females. All of these factors predispose to a more severe course of the disease.…”

Section: Discussioncontrasting

confidence: 58%

Gender differences in the Scandinavian cystic fibrosis population

Olesen¹,

Pressler²,

Hjelte³

et al. 2010

Pediatric Pulmonology

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AimsTo explore whether gender differences in the Scandinavian Cystic Fibrosis (CF) patients exist in the areas of key clinical parameters, complications, and medication.MethodsCross‐sectional data on 890 (416 female) pancreatic insufficient CF patients were evaluated regarding chronic infection, body mass index, lung function, medication, and diabetes, as well as data of Pseudomonas infection status, antibiotic treatment and hospitalization from 1‐year follow‐up.ResultsWe found no differences in lung function, body mass index, or frequency of diabetes. The adult group consisted of more males than females (208:168). We found no significant difference in prevalence of chronic Pseudomonas aeruginosa infection, but during the follow‐up the incidence of new chronic infection was higher in adult females (10/33 vs. 4/56). Females had higher prevalence of Burkholderia infection (21/416 vs. 11/474). Adult females had more days on intravenous antibiotics (median 39 vs. 26 days/year), and days in hospital (median 2 vs. 0 days/year). More adult females received inhaled and oral steroids. In the pediatric cohort, females were treated more often with macrolides as an anti‐inflammatory agent.ConclusionWe found no gender difference in key clinical parameters in our CF population. However, our study showed a higher risk of Pseudomonas and Burkholderia infection among the female patients. Additionally, we found that female patients require more intensified treatment regarding antibiotics, macrolides, steroids and days of hospitalization, indicating a true female disadvantage even with modern aggressive treatment. The finding of more males than females in the adult population suggesting a male advantage, warrants a mortality study. Pediatr Pulmonol. 2010; 45:959–965. © 2010 Wiley‐Liss, Inc.

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Section: Discussioncontrasting

confidence: 58%

Gender differences in the Scandinavian cystic fibrosis population

Olesen¹,

Pressler²,

Hjelte³

et al. 2010

Pediatric Pulmonology

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“…Initially, infection can be intermittent and involve multiple strains. Eventually, a single strain dominates and establishes chronic infection, which is most often marked by a shift in the infecting strain to a mucoid phenotype (117). Eradication of pulmonary infection after this point is generally not possible.…”

Section: Pseudomonas Aeruginosamentioning

confidence: 99%

The Changing Microbial Epidemiology in Cystic Fibrosis

2010

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SUMMARY Infection of the airways remains the primary cause of morbidity and mortality in persons with cystic fibrosis (CF). This review describes salient features of the epidemiologies of microbial species that are involved in respiratory tract infection in CF. The apparently expanding spectrum of species causing infection in CF and recent changes in the incidences and prevalences of infection due to specific bacterial, fungal, and viral species are described. The challenges inherent in tracking and interpreting rates of infection in this patient population are discussed.

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“…Pseudomonas aeruginosa is an opportunistic organism involved in chronic lung infection in patients with cystic fibrosis (CF) and is a leading cause of nosocomial infections [1]. Such infections are difficult to treat because of intrinsic and acquired resistance to antibiotics, including aminoglycosides, in P. aeruginosa isolates from CF patients.…”

Section: Introductionmentioning

confidence: 99%

Expression of the MexXY efflux pump in amikacin-resistant isolates of Pseudomonas aeruginosa

Islam

Jalal

Wretlind

2004

Clinical Microbiology and Infection

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The MexZ-MexX-MexY multidrug efflux system in Pseudomonas aeruginosa was studied to determine its contribution to aminoglycoside resistance. Amikacin-resistant (AR) mutants were generated from P. aeruginosa strain PAO1, and clinical isolates of P. aeruginosa were collected from cystic fibrosis patients. The regulatory gene mexZ and the intergenic region (mexOZ) between mexZ and mexX were investigated for mutation by PCR and DNA sequence analysis. The results showed that 14 of 15 AR clinical isolates and one of ten laboratory mutants had at least one mutation in mexZ and/or mexOZ. To study the effect of mexZ and mexOZ mutations, the production of MexY mRNA was investigated quantitatively by real-time PCR. Seven of ten AR mutants (MIC 4-8 mg/L) produced 8-21-fold more MexY mRNA than PAO1. These isolates were sensitive to fluoroquinolones, carbapenems and ceftazidime. One AR mutant (MIC 64 mg/L) that produced > 200-fold more MexY mRNA than PAO1 was also resistant to fluoroquinolones, carbapenems and ceftazidime. Thirteen of 15 AR clinical isolates produced 3.4-727-fold more MexY mRNA. No evidence was found for the aminoglycoside-modifying enzymes 6'-N-acetyltransferase type Ib, 4'-O-nucleotidyltransferase type IIb or aminoglycoside 3'-phosphotransferase IIps in these strains. Nine AR mutants overproduced MexY without mutations in mexZ or mexOZ, suggesting that MexXY efflux is also regulated by gene(s) other than mexZ.

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Microbial pathogenesis in cystic fibrosis: mucoid Pseudomonas aeruginosa and Burkholderia cepacia.

Cited by 1,234 publications

References 394 publications

Gender differences in the Scandinavian cystic fibrosis population

Gender differences in the Scandinavian cystic fibrosis population

The Changing Microbial Epidemiology in Cystic Fibrosis

Expression of the MexXY efflux pump in amikacin-resistant isolates of Pseudomonas aeruginosa

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