Genotypic characterization of Pseudomonas aeruginosa strains recovered from patients with cystic fibrosis after initial and subsequent colonization.
Chronic infection by Pseudomonas aeruginosa (PA) in patients with cystic fibrosis (CF) is preceded by a period of colonization and acute infection. Early aggressive antibiotic treatment of initial colonisation may prevent or at least delay chronic pulmonary infection. We initiated treatment with a combination of IV beta-lactam tobramycin, followed by nebulized colistin when PA was first isolated from patients with CF. Subsequent serial PA isolates obtained from these colonized CF patients were characterized by means of molecular methods to determine whether they were genetically related to the initial strain. Initial colonization was eradicated in all 19 patients. All patients reacquired PA within 3-25 months during the 3 years of follow-up. Fourteen patients acquired a new PA strain with a distinct genotypic profile, suggesting a new source of contamination. Five patients had two PA isolates with identical genotypes, suggesting either previous undetected respiratory tract colonization or a persistent environmental source of contamination.
Munck
A
A
Service de Gastroentérologie, Hôpital Robert Debré, Paris, France.
Bonacorsi
S
S
Mariani-Kurkdjian
P
P
Lebourgeois
M
M
Gérardin
M
M
Brahimi
N
N
Navarro
J
J
Bingen
E
E
D000280:Administration, Inhalation; D000284:Administration, Oral; D002442:Ceftazidime / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003091:Colistin / Q000008:administration & dosage; D015169:Colony Count, Microbial; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis*; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage; D007223:Infant; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy*; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000235:genetics*; D018570:Risk Assessment; D014031:Tobramycin / Q000008:administration & dosage
D004269:DNA, Bacterial; D015378:Imipenem; D002442:Ceftazidime; D014031:Tobramycin; D003091:Colistin