Pseudomonas Cepacia in the Respiratory Flora of Patients With Cystic Fibrosis (Cf)

Abstract

402 grew Pseudomonas(Ps.) cepacia. I n 208 c u l t u r e s , i t was t h e s i n g l e i s o l a t e . and i n 194 i t grew together with Staphylococcus aureus andlor Ps. aeruginos a , o r t o g e t h e r w i t h other gram-negative organisms. A t o t a l of 54 p a t i e n t s , (24 t o 22 y e a r s ) , 32 females and 22 males, with mild (2). moderate(l5) and advanced(37) degrees of CF has Ps. cepacia i s o l a t e d from b r o n c h i a l o r sputum c u l t u r e s . Ps. cepacia has been found i n p a t i e n t s who have never been h o s p i t a l i z e d and i n those who r a r e l y used a e r o s o l therapy. I t was recovered c o n s i s t e n t l y f o r 2 t o 3 years from 17 p a t i e n t s . Nine females and 5 males have died from r e s p i r a t o r y f a i l u r e . Premortem c u l t u r e s i n 12 p a t i e n t s grew Ps. cepacia alone o r together with Ps. aeruginosa. I n 10 autopsied c a s e s , the lung c u l t u r e grew Ps. cepacia alone i n 3 and Pa. aeruginosa i n 4. Pa. cepacia is r e s i s t a n t t o almost a l l a n t imicrobials including n a l i d i x i c a c i d and g a n t r i s i n b u t a few a r e s e n s i t i v e t o chloramphenicol. trimethoprim-sulfamethoxazole (TMP-SXT) and kanamycin. Good c l i n i c a l response has been observed i n those t r e a t e d w i t h TMP-SXT o r chloramphenicol. Transient d i sappearance of Ps. cepacia i n post-therapy c u l t u r e s has been achieved i n a few cases. The s i g n i f i c a n c e of t h i s f i n d i n g i s under study. The s u p e r i n f e c t i o n with Ps. cepacia of p a t i e n t s with CF with advanced d i s e a s e has made the a n t i m i c r o b i a l therapy more d i f f i c u l t . TEICHOIC ACID SEROLOGY I N VARIOUS STAPHYLO- COCCAL COAGULASE P O S I T I V E I N F E C T I O N S I N INFANTS AND CHILDREN.C h i n h T. Le a n d Edward B. Lewin ( S p o n . by M a r t i n R. K l e m p e r e r ) . U n i v . o f R o c h e s t e r S c h . o f Med. a n d D e n t . , S t r o n g M e m o r i a l H o s p i t a l , D e p a r t m e n t o f P e d i a t r i c s , R o c h e s t e r . N . Y .C o u n t e r i m m u n o e l e c t r o p h o r e s i s ( C I E ) a n d O u c h t e rl o n y g e l d i f f u s i o n w e r e u s e d f o r t h e d e t e c t i o n a n d t i t r a t i o n o f a n t i c o a g . p o s i t i v e (SC+) i n i n f a n t s a n d c h i l d r e n . Serum s a m p l e s w e r e o b t a i n e d o n a d m i s s i o n , a t 2 w e e k s , a n d up t o 1 2 w e e k s i n t o t h e i l l n e s s .TAA w e r e f o u n d by CIE i n 7 0 % ( 7 1 1 0 ) o f p a t i e n t s w i t h i n v a s i v e SC+ d is e a s e w i t h b a c t e r e m i a ( g r o u p A). 1 4 % ( 1 1 7 ) o f p at i e n t s w i t h SC+ i n f e c t i o n w i t h o u t b a c t e r e m i a ( g r o u p B ) , 0 % ( 0 1 1 9 ) o f p a t i e n t s w i t h b a c t e r e m i a a n d l o r i n v a s i v e i n f e c t i o n s n o t c a u s e d by SC+ ( g r o u p C ) a n d 0 % ( 0 1 1 3 ) o f n o n -i n f e c t e d , h o s p i t a l i z e d p a t i e n t s a n d h e a l t h y c h i l d r e...

Outcome of Burkholderia cepacia colonisation in an adult cystic fibrosis centre

“…This was first described as an opportunistic organism in CF in 1972, 21 and its prevalence increased in North America following this. [22][23][24][25] Epidemic B cepacia strains which can be easily transmitted between CF patients were first described in the USA in 1984, 26 and by 1989 such a strain (ET12) had entered the UK CF population. 27 We have recently shown that this strain is capable of crosscolonising CF patients already infected with B cepacia, often with fatal consequences, 8 and can also colonise non-CF relatives causing serious morbidity.…”

Multiple Combination Bactericidal Antibiotic Testing for Patients with Cystic Fibrosis Infected with Burkholderia cepacia

“…Burkholderia cepacia bacteria was first recovered from sputum cultures of patients with cystic fibrosis (CF) in the late 1970s (1). By 1984 a syndrome characterized by severe progressive respiratory failure, necrotizing pneumonia, and B. cepacia bacteremia was described and was termed "cepacia syndrome" (2).…”

Burkholderia cepacia complex: a contraindication to lung transplantation in cystic fibrosis?

“…However, sporadic human infections were reported (4–6), as were descriptions of “pseudo‐epidemics” (7, 8) and true nosocomial infections (9, 10) due to the use of contaminated disinfectants and anaesthetic solutions. In the late 1970s, some CF treatment centers reported the recovery of B. cepacia from CF sputum culture (11, 12). A report from Toronto in 1982 noted that 45% of CF patients enrolled in a study of prophylactic antibiotic use were infected with B. cepacia (13).…”