Pseudomonas aeruginosa diversity and adaptation in the non-Cystic Fibrosis bronchiectasis lung

Hilliam, Yasmin; Moore, Matthew; Lamont, Iain L.; Haworth, C.S.; Foweraker, Juliet; Bilton, Diana; Walshaw, Martin; Fothergill, Joanne L.; Soyza, Anthony De; Winstanley, Craig

doi:10.1055/s-0036-1592242

Cited by 21 publications

(37 citation statements)

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“…Our results found that no major Australian CF shared P. aeruginosa strains were detected in our current cohort. In fact, our study found no evidence of shared P. aeruginosa strain infections, which is in keeping with the published data that shared P. aeruginosa strains are uncommon in patients with bronchiectasis or COPD . The P. aeruginosa strains detected in our study are commonly found in other niches, such as the natural environment and non‐CF infections .…”

Section: Discussionsupporting

confidence: 92%

“…In (non‐CF) bronchiectasis and chronic obstructive pulmonary disease (COPD), P. aeruginosa predominantly causes infection in those with severe disease and is associated with poorer prognosis, higher mortality and increased hospital admissions . Yet, unlike CF, cross‐infection with P. aeruginosa is reported to be uncommon in patients with bronchiectasis and COPD . Although the evidence for cross‐infection is infrequent in non‐CF suppurative lung diseases, the transmission mechanism of possible person‐to‐person transmission events has not been studied previously.…”

Section: Introductionmentioning

confidence: 99%

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Transmission of bacteria in bronchiectasis and chronic obstructive pulmonary disease: Low burden of cough aerosols

et al. 2019

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Background and objective Aerosol transmission of Pseudomonas aeruginosa has been suggested as a possible mode of respiratory infection spread in patients with cystic fibrosis (CF); however, whether this occurs in other suppurative lung diseases is unknown. Therefore, we aimed to determine if (i) patients with bronchiectasis (unrelated to CF) or chronic obstructive pulmonary disease (COPD) can aerosolize P. aeruginosa during coughing and (ii) if genetically indistinguishable (shared) P. aeruginosa strains are present in these disease cohorts. Methods People with bronchiectasis or COPD and P. aeruginosa respiratory infection were recruited for two studies. Aerosol study: Participants (n = 20) underwent cough testing using validated cough rigs to determine the survival of P. aeruginosa aerosols in the air over distance and duration. Genotyping study: P. aeruginosa sputum isolates (n = 95) were genotyped using the iPLEX20SNP platform, with a subset subjected to the enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC‐PCR) assay to ascertain their genetic relatedness. Results Aerosol study: Overall, 7 of 20 (35%) participants released P. aeruginosa cough aerosols during at least one of the cough aerosol tests. These cough aerosols remained viable for 4 m from the source and for 15 min after coughing. The mean total aerosol count of P. aeruginosa at 2 m was two colony‐forming units. Typing study: No shared P. aeruginosa strains were identified. Conclusion Low viable count of P. aeruginosa cough aerosols and a lack of shared P. aeruginosa strains observed suggest that aerosol transmission of P. aeruginosa is an unlikely mode of respiratory infection spread in patients with bronchiectasis and COPD.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Transmission of bacteria in bronchiectasis and chronic obstructive pulmonary disease: Low burden of cough aerosols

et al. 2019

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“…However, in that study, patients with NCFB were managed at a different site from the local CF cohort. Similarly, a recent multicentre study highlighted the potential for PA cross-infection, although this was again exclusively focused on NCFB cohorts 4. In many hospitals, including ours, patients with CF and NCFB share facilities and healthcare professionals.…”

mentioning

confidence: 93%

Molecular epidemiology of Pseudomonas aeruginosa in an unsegregated bronchiectasis cohort sharing hospital facilities with a cystic fibrosis cohort

Mitchelmore

Randall

Bull

et al. 2017

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While (PA) cross-infection is well documented among patients with cystic fibrosis (CF), the equivalent risk among patients with non-CF bronchiectasis (NCFB) is unclear, particularly those managed alongside patients with CF. We performed analysis of PA within a single centre that manages an unsegregated NCFB cohort alongside a segregated CF cohort. We found no evidence of cross-infection between the two cohorts or within the segregated CF cohort. However, within the unsegregated NCFB cohort, evidence of cross-infection was found between three (of 46) patients. While we do not presently advocate any change in the management of our NCFB cohort, longitudinal surveillance is clearly warranted.

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“…For example, whole‐genome sequencing (WGS) of P . aeruginosa from cystic fibrosis (CF) and bronchiectasis patients reveals how this key pathogen adapts to the airway . In a study of 189 isolates from bronchiectasis patients, Hilliam et al have shown multiple mutations during chronic P .…”

Section: Whole Genome Sequencing Of Bacteriamentioning

confidence: 99%

“…In a study of 189 isolates from bronchiectasis patients, Hilliam et al have shown multiple mutations during chronic P . aeruginosa infection including those affecting mucoid phenotype (mucA), quorum sensing (lasR), iron acquisition and antibiotic resistance . These studies show marked genetic variation among strains infecting different patients, but also in different strains from the same patient emphasizing an important clinical lesson: that strong conclusions cannot be drawn from antibiotic susceptibility or virulence data from a single isolate in chronic respiratory infections .…”

Section: Whole Genome Sequencing Of Bacteriamentioning

confidence: 99%

The past decade in bench research into pulmonary infectious diseases: What do clinicians need to know?

et al. 2017

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Respiratory infections are primarily treated with antibiotics, drugs that are mostly inexpensive and have been widely available since the 1940s and 1950s. Nevertheless, despite antibiotics, the burden of disease in pneumonia, bronchiectasis, cystic fibrosis, COPD and rare respiratory infections remains exceptionally high. There is an urgent need for translational studies to develop new treatments or new biomarkers to improve outcomes in these conditions. The 'translational gaps' between bench science and clinical practice are particularly challenging in respiratory infections. This is partly due to the poor representativeness of animal models of infection to human disease, and a long-term lack of investment into pulmonary infection research. The revolution in genomics and other omics technologies, however, is beginning to unlock clinically important information about the host response to infection, the behaviour of bacterial communities and the development of new antibiotics. It is not possible to review the extensive progress made in the last decade into the pathophysiology of the different respiratory infections and so here, we focus on major technologies that are now changing respiratory infection research, specifically bacterial whole-genome sequencing, the microbiota, personalized medicine with omics technologies, new antibiotic development and host inflammatory cell biology.

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Pseudomonas aeruginosa diversity and adaptation in the non-Cystic Fibrosis bronchiectasis lung

Cited by 21 publications

References 0 publications

Transmission of bacteria in bronchiectasis and chronic obstructive pulmonary disease: Low burden of cough aerosols

Transmission of bacteria in bronchiectasis and chronic obstructive pulmonary disease: Low burden of cough aerosols

Molecular epidemiology of Pseudomonas aeruginosa in an unsegregated bronchiectasis cohort sharing hospital facilities with a cystic fibrosis cohort

The past decade in bench research into pulmonary infectious diseases: What do clinicians need to know?

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