The combination of PCR and serology increases the diagnosis of <i>Pseudomonas aeruginosa</i> colonization/infection in cystic fibrosis

Filho, Luiz Vicente Ferreira da Silva; Tateno, Adriana Fumie; Martins, Kátia Maia; Chernishev, Ana Carolina Azzuz; Garcia, Doroti de Oliveira; Haug, Markus; Meisner, Christoph; Rodrigues, Joaquim Carlos; Döring, Gerd

doi:10.1002/ppul.20686

Cited by 34 publications

(48 citation statements)

References 33 publications

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“…The use of such techniques would probably have changed the result of the study because the use of PCR and serology in combination has been shown to be superior to the use of each method in isolation, to the combined use of PCR and culture, and to the combined use of culture and serology. (14) The nebulizers used by the CF patients analyzed in the present study presented with a low rate of bacterial growth, although most of the patients did not often use disinfection procedures. There were no associations between the types of bacteria found in the sputum/ oropharynx of patients and those found in the nebulizer parts (mask, mouthpiece, and chamber).…”

Section: Discussionmentioning

confidence: 76%

Nebulizadores: fonte de contaminação bacteriana em pacientes com fibrose cística?

Brzezinski¹,

Riedi

Kussek³

et al. 2011

J. bras. pneumol.

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Objective: To determine whether nebulizers are a source of microbial contamination in patients with cystic fibrosis, as well as whether the technique and frequency of disinfection of these devices is appropriate. Methods: This was a cross-sectional, uncontrolled observational study. Samples were collected from 28 patients with cystic fibrosis. Samples were collected at the homes of the patients, who were not previously informed of the purpose of the visit. Three samples were collected from each patient: one from the nebulizer chamber, one from the mask/mouthpiece, and one from the patient (oropharyngeal swab/sputum). The samples were properly stored and taken for analyses. The patients, their parents, or their legal guardians completed a questionnaire regarding nebulizer cleaning and disinfecting methods. Results: We collected 84 samples from the 28 patients. Of those 28 patients, 15 (53.5%) were male. The median age of the patients was 11 years (range, 1-27 years). Of the 28 patients, 15 presented with positive oropharyngeal swab/sputum sample cultures. The most common bacterial isolates were Staphylococcus aureus (in 8 patients) and Pseudomonas aeruginosa (in 4 patients). Although the samples obtained from the nebulizers presented with various pathogens in culture, no specific species predominated. In 27 cases (96.7%), there were no associations between the samples obtained from the nebulizers and those obtained from the patients in terms of the results of the cultures. Cleaning and disinfection of nebulizers were inappropriate in 22 cases (78.6%). Conclusions: In this sample of patients, despite the inappropriate disinfection techniques, nebulizers were not found to be a source of microbial contamination.Keywords: Cystic fibrosis; Nebulizers and vaporizers; Disinfection. ResumoObjetivo: Determinar se os nebulizadores de pacientes com fibrose cística são fonte de contaminação microbiana e verificar se a técnica e a frequência de desinfecção dos nebulizadores é apropriada. Métodos: Estudo de corte transversal observacional, sem grupo controle. Foram coletadas amostras de 28 pacientes com fibrose cística, no domicílio do paciente, sem aviso prévio sobre o motivo da visita. Foram colhidas três amostras por paciente: do reservatório do nebulizador, da máscara/bocal e do próprio paciente (swab da orofaringe/escarro). As amostras foram acondicionadas adequadamente e levadas para análise. Os pacientes, seus pais ou responsáveis preencheram um questionário sobre métodos de limpeza e desinfecção dos nebulizadores. Resultados: Foram obtidas 84 amostras dos 28 pacientes. Destes, 15 (53,5%) eram do gênero masculino. A mediana de idade foi de 11 anos (variação: 1-27 anos). Dos 28 pacientes, 15 apresentaram culturas de escarro/orofaringe positivas. As bactérias encontradas com maior frequencia foram Streptococcus aureus (8/15) e Pseudomonas aeruginosa (4/15). A cultura obtida dos nebulizadores identificou diversos patógenos, sem nenhum predominante. Não houve associações entre os resultados das culturas obtidas dos ...

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Section: Discussionmentioning

confidence: 76%

Nebulizadores: fonte de contaminação bacteriana em pacientes com fibrose cística?

Brzezinski¹,

Riedi

Kussek³

et al. 2011

J. bras. pneumol.

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“…A further study using a combination of PCR and Serology showed that it was possible to isolate P. aeruginosa by culture in samples from 42 patients (48.2%), while PCR was positive in 53 (60.9%) [14]. Our results show that in cough swabs P. aeruginosa was positive by culture in 5% samples (11% patients) , while PCR was positive in 11% samples (16% patients) and in sputa P. aeruginosa was positive by culture in 52% of samples (44% patients), while PCR was positive in 76% samples (76% patients).…”

Section: Discussionmentioning

confidence: 92%

Improved early diagnosis of Pseudomonas aeruginosa by real-time PCR to prevent chronic colonisation in a paediatric cystic fibrosis population

McCulloch

Lucas

Ramage

et al. 2011

Journal of Cystic Fibrosis

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Early detection of Pseudomonas aeruginosa in children with cystic fibrosis is hampered by the need to process a sub-optimal specimen type, namely cough swabs, which are known to have a lower positive yield than sputa or more invasive samples. This delay in the detection of low levels of P. aeruginosa could potentially result in the loss of an opportunity to initiate early aggressive antibiotic therapy and result in chronic colonisation, with a poorer overall prognosis. Quantitative real-time PCR (qPCR) offers an opportunity to increase the detection rate of P. aeruginosa compared to traditional culture techniques. This study examined 500 cough swabs and 42 sputum samples from paediatric patients and showed that detection of P. aeruginosa could be increased in both sample types by 100% and 45% respectively. Overall the sensitivity was 100% and specificity of 58% when compared to culture as a gold standard. These results although initially promising require careful consideration both from a treatment and infection control standpoint as the significance of detection of very low levels of P. aeruginosa is unclear.

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“…Most of the studies, comparing the sensitivity of culture and PCR for the detection of P. aeruginosa, are cross-sectional [11,12,[16][17][18][19][20][21]. In all of these studies, an equal or increased detection rate was found with PCR in comparison with culture (Table 2).…”

Section: Sensitivity Of the Qpcr Formatsmentioning

confidence: 94%

PCR and the detection of Pseudomonas aeruginosa in respiratory samples of CF patients. A literature review

Deschaght¹,

Daele

Baets

et al. 2011

Journal of Cystic Fibrosis

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Previous studies proved the importance of rapid antibacterial intervention in case of Pseudomonas aeruginosa detection in respiratory samples of cystic fibrosis patients. To improve the early detection of P. aeruginosa, several culture, PCR and serology based approaches have been compared. Because an increasing number of routine microbiology laboratories have access to real-time PCR (qPCR), we reviewed the specificity and sensitivity of published PCR formats. The importance of choice of DNA-extraction methods and PCR formats and of the validation of their specificity and sensitivity with clinical samples is stressed.

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The combination of PCR and serology increases the diagnosis of Pseudomonas aeruginosa colonization/infection in cystic fibrosis

Cited by 34 publications

References 33 publications

Nebulizadores: fonte de contaminação bacteriana em pacientes com fibrose cística?

Nebulizadores: fonte de contaminação bacteriana em pacientes com fibrose cística?

Improved early diagnosis of Pseudomonas aeruginosa by real-time PCR to prevent chronic colonisation in a paediatric cystic fibrosis population

PCR and the detection of Pseudomonas aeruginosa in respiratory samples of CF patients. A literature review

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