Superinfection with a transmissible strain of Pseudomonas aeruginosa in adults with cystic fibrosis chronically colonised by P aeruginosa

Mccallum, S; Corkill, J. E.; Gallagher, Malcolm; Ledson, M.J.; Hart, C. A.; Walshaw, Martin

doi:10.1016/s0140-6736(01)05715-4

Cited by 147 publications

(113 citation statements)

References 5 publications

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“…In total, 59% of the patients harboured a clonal strain. Whilst a paediatric clonal strain has been previously described within an adult CF clinic [26], to the current authors9 knowledge, this is the first study to attempt to investigate the extent of P. aeruginosa transmission across geographically distinct clinics. The current findings provide further evidence that clonal strains of P. aeruginosa are an important issue and it is believed that this problem will continue to emerge and pose significant clinical and infection-control dilemmas for many, but not necessarily all, CF units.…”

Section: Discussionmentioning

confidence: 99%

Clonal strains of Pseudomonas aeruginosa in paediatric and adult cystic fibrosis units

O’Carroll¹,

Syrmis²,

Wainwright³

et al. 2004

European Respiratory Journal

103

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Despite recent reports of clonal strains of Pseudomonas aeruginosa in cystic fibrosis (CF) units, the need for routine microbiological surveillance remains contentious.Sputum was collected prospectively from productive patients attending the regional paediatric and adult CF units in Brisbane, Australia. All P. aeruginosa isolates were typed using pulsed-field gel electrophoresis. Spirometry, anthropometrics, hospitalisations and antibiotic sensitivity data were recorded.The first 100 sputum samples (first 50 patients at each clinic) harboured 163 isolates of P. aeruginosa. A total of 39 patients shared a common strain (pulsotype 2), 20 patients shared a strain with at least one other patient and 41 patients harboured unique strains. Eight patients shared a strain identical to a previously reported Australian transmissible strain (pulsotype 1). Compared with the unique strain group, patients harbouring pulsotype 2 were younger and had poorer lung function. Treatment requirements were similar in these two groups, as were the rates of multiresistance.In conclusion, 59% of patients harboured a clonal strain, supporting the need for routine microbiological surveillance. In contrast to previously described clonal strains, the dominant pulsotype was indistinguishable from nonclonal strains with respect to both colonial morphology and multiresistance. The clinical significance of clonal strains remains uncertain and requires longitudinal study.

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Section: Discussionmentioning

confidence: 99%

Clonal strains of Pseudomonas aeruginosa in paediatric and adult cystic fibrosis units

O’Carroll¹,

Syrmis²,

Wainwright³

et al. 2004

European Respiratory Journal

103

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“…The strain can cause superinfection of patients previously chronically infected with a different strain of P. aeruginosa [34]. In addition, the LES has caused respiratory infections of both non-CF parents of the same CF patient [35], with infections lasting for over 5 yrs (unpublished data).…”

Section: The Liverpool Epidemic Strain Prevalence and Clinical Featurmentioning

confidence: 97%

Transmissible strains ofPseudomonas aeruginosain cystic fibrosis lung infections

Fothergill¹,

Walshaw²,

Winstanley³

2012

Eur Respir J

145

122

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Pseudomonas aeruginosa chronic lung infections are the major cause of morbidity and mortality associated with cystic fibrosis. For many years, the consensus was that cystic fibrosis patients acquire P. aeruginosa from the environment, and hence harbour their own individual clones. However, in the past 15 yrs the emergence of transmissible strains, in some cases associated with greater morbidity and increased antimicrobial resistance, has changed the way that many clinics treat their patients. Here we provide a summary of reported transmissible strains in the UK, other parts of Europe, Australia and North America. In particular, we discuss the prevalence, epidemiology, unusual genotypic and phenotypic features, and virulence of the most intensively studied transmissible strain, the Liverpool epidemic strain. We also discuss the clinical impact of transmissible strains, in particular the diagnostic and infection control approaches adopted to counter their spread. Genomic analysis carried out so far has provided little evidence that transmissibility is due to shared genetic characteristics between different strains. Previous experiences with transmissible strains should help us to learn lessons for the future. In particular, there is a clear need for strain surveillance if emerging problem strains are to be detected before they are widely transmitted.

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“…Currently, some CF centres report the spread of highly transmissible P. aeruginosa strains that are multi-drug resistant and, in some patients, are responsible for primary infection [7][8][9][10][11][12]. Other studies, however, have not found evidence of clonal spread [13][14][15][16].…”

mentioning

confidence: 99%

Survey of Pseudomonas aeruginosa genotypes in colonised cystic fibrosis patients

Daele¹

2006

European Respiratory Journal

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The current authors aimed to examine whether cystic fibrosis (CF) patients in Belgium shared Pseudomonas aeruginosa genotypes and to compare the genotypes of isolates from the same patients during two consecutive years. A Belgian databank of the P. aeruginosa genotypes of all colonised CF patients was created.Sputum samples from a total of 276 P. aeruginosa colonised patients during 2003, and from a subgroup of 95 patients in 2004, were analysed. Patients were asked about any social contact between each other by questionnaire. All P. aeruginosa isolates exhibiting different colonial morphology on McConkey agar were first genotyped using arbitrarily primed PCR, whereafter single representatives of each randomly amplified polymorphic DNA-type were further genotyped by fluorescent amplified fragment length polymorphism analysis.In the 213 patients from whom P. aeruginosa could be cultured (resulting in 910 isolates), a total of 163 genotypes were found. The majority (75%) of patients harboured only one genotype. In most of the limited number of clusters, previous contacts between patients could be suspected. In 80% of the patients studied during both years, P. aeruginosa genotype remained unchanged.In conclusion, most colonised cystic fibrosis patients harbour only one Pseudomonas aeruginosa genotype, despite showing different colonial morphotypes. The number of clusters is limited, and most patients seem to retain the same genotypic strain during both years.

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Superinfection with a transmissible strain of Pseudomonas aeruginosa in adults with cystic fibrosis chronically colonised by P aeruginosa

Cited by 147 publications

References 5 publications

Clonal strains of Pseudomonas aeruginosa in paediatric and adult cystic fibrosis units

Clonal strains of Pseudomonas aeruginosa in paediatric and adult cystic fibrosis units

Transmissible strains ofPseudomonas aeruginosain cystic fibrosis lung infections

Survey of Pseudomonas aeruginosa genotypes in colonised cystic fibrosis patients

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