Respiratory Bacterial Culture Sampling in Expectorating and Non-expectorating Patients With Cystic Fibrosis

Eyns, H.; Piérard, Denis; Wachter, Elke De; Eeckhout, Leo; Vaes, Peter; Malfroot, Anne

doi:10.3389/fped.2018.00403

Cited by 25 publications

(18 citation statements)

References 37 publications

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“…However, the major limitation of this study was the use of cough swabs to screen the respiratory tract metagenome. Whereas bronchoalveolar lavage (BAL) or induced sputum are gold standards for diagnosing lower airway infection, and investigating the lower respiratory tract metagenome 46 , 47 , throat swabs were often assigned as unsuitable for studying bacterial conditions in the CF lung due to a low test sensitivity (34–36%) 48 , 49 . While newborns and infants do not produce sputum, BAL is an invasive technique and inappropriate for use in longitudinal studies with short sampling intervals or for including a sufficient number of healthy controls.…”

Section: Discussionmentioning

confidence: 99%

The human respiratory tract microbial community structures in healthy and cystic fibrosis infants

Pust

Wiehlmann

Davenport

et al. 2020

npj Biofilms Microbiomes

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The metagenome development of the human respiratory tract was investigated by shotgun metagenome metagenomic sequencing of cough swabs from healthy children and children with cystic fibrosis (CF) between 3 weeks and 6 years of age. A healthy microbial community signature was associated with increased absolute abundances in terms of bacterial–human cell ratios of core and rare species across all age groups, with a higher diversity of rare species and a tightly interconnected species co-occurrence network, in which individual members were found in close proximity to each other and negative correlations were absent. Even without typical CF pathogens, the CF infant co-occurrence network was found to be less stable and prone to fragmentation due to fewer connections between species, a higher number of bridging species and the presence of negative species correlations. Detection of low-abundant DNA of the CF hallmark pathogen Pseudomonas aeruginosa was neither disease- nor age-associated in our cohort. Healthy and CF children come into contact with P. aeruginosa on a regular basis and from early on.

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Section: Discussionmentioning

confidence: 99%

The human respiratory tract microbial community structures in healthy and cystic fibrosis infants

Pust

Wiehlmann

Davenport

et al. 2020

npj Biofilms Microbiomes

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“…Since the advent of triple modulator therapy [ 20 – 22 ], many patients are no longer producing sputum, however they are likely still colonized with bacteria as was seen in previous cohorts with mutations for which highly effective modulator therapy is available [ 23 ]. Bronchoscopy may be able to aid in the characterization of colonizing bacteria in these patients [ 24 ]. Specific risks to CF patients are mostly studied in children, and include a higher incidence of transient fever [ 25 ], however these are difficult to differentiate from early CF exacerbations that may have happened irrespective of bronchoscopy.…”

Section: Introductionmentioning

confidence: 99%

Safety of research bronchoscopy with BAL in stable adult patients with cystic fibrosis

et al. 2021

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Data on adverse events from research bronchoscopy with bronchoalveolar lavage (BAL) in patients with cystic fibrosis (CF) is lacking. As research bronchoscopy with BAL is useful for isolation of immune cells and investigation of CF lung microbiome, we sought to investigate the safety of bronchoscopy in adult patients with CF. Between November 2016 and September 2019, we performed research bronchoscopies on CF subjects (32) and control subjects (82). Control subjects were nonsmokers without respiratory disease. CF subjects had mild or moderate obstructive lung disease (FEV1 > 50% predicted) and no evidence of recent CF pulmonary exacerbation. There was no significant difference in the age or sex of each cohort. Neither group experienced life threatening adverse events. The number of adverse events was similar between CF and control subjects. The most common adverse events were sore throat and cough, which occurred at similar frequencies in control and CF subjects. Fever and headache occurred more frequently in CF subjects. However, the majority of fevers were seen in CF subjects with FEV1 values below 65% predicted. We found that CF subjects had similar adverse event profiles following research bronchoscopy compared to healthy subjects. While CF subjects had a higher rate of fevers, this adverse event occurred with greater frequency in CF subjects with lower FEV1. Our data demonstrate that research bronchoscopy with BAL is safe in CF subjects and that safety profile is improved if bronchoscopies are limited to subjects with an FEV1 > 65% predicted.

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“…Per CLSI guidelines, only species with a minimum of 30 isolates during the study period were included in the CFA. 11 No other isolates were included. Antimicrobial susceptibility information was collected for all CF isolates.…”

Section: Methodsmentioning

confidence: 99%

“…This methodology was based on CLSI guidance for handling multiple isolates within the same year. 11 The CF antibiogram was compared to the HWA each year. The HWA is an annual compilation of systemwide susceptibility results from cultures from all sources.…”

Section: Methodsmentioning

confidence: 99%

Development and Anaysis of a Cystic Fibrosis Specific Antibiogram

Elson¹,

Meier²,

Swanson³

et al. 2021

Preprint

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BACKGROUND: Antibiotic therapy is essential for the treatment of cystic fibrosis (CF) lung infections. CF-specific airway pathophysiology and frequent antimicrobial exposure increase the risk of resistant infections, creating challenges to antibiotic selection. Antibiotic selection is generally based on previous cultures or hospital-wide antibiograms (HWA); however, most HWA exclude CF isolates. We developed a multi-year CF antibiogram (CFA) to compare with HWA and inform antibiotic selection. METHODS: CF culture data were collected 2015 - 2019 at a single pediatric CF center. All sputum and oropharyngeal swab isolates are included in the CFA. Demographics, microorganism isolates, and susceptibility information are presented. Susceptibilities were reported for methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa (PA), Achromobacter species, Burkholderia species and Stenotrophomonas maltophilia. RESULTS: Over five years, the proportion of all SA isolates having methicillin-resistance was higher in the HWA (32%) than the CFA (28%). The most common gram-negative CF isolate was PA. Both gram-positive and gram-negative microorganisms were less susceptible in the CFA versus the HWA. CF isolates from sputum were less susceptible than oropharyngeal. MSSA and MRSA had significantly lower clindamycin susceptibility in the CFA compared to the HWA (MSSA 71% vs 79%, p<0.0001 and MRSA 39% vs 83%, p<0.0001). For every antimicrobial tested, PA isolates were less susceptible in the CFA compared to the HWA. There did not appear to be significant changes in susceptibility of CF isolates over time. CONCLUSIONS: These findings have clinical implications for empiric antimicrobial selection. A CFA will allow monitoring of resistance over time.

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Respiratory Bacterial Culture Sampling in Expectorating and Non-expectorating Patients With Cystic Fibrosis

Cited by 25 publications

References 37 publications

The human respiratory tract microbial community structures in healthy and cystic fibrosis infants

The human respiratory tract microbial community structures in healthy and cystic fibrosis infants

Safety of research bronchoscopy with BAL in stable adult patients with cystic fibrosis

Development and Anaysis of a Cystic Fibrosis Specific Antibiogram

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