title: Increased treatment requirements of patients with cystic fibrosis who harbour a highly transmissible strain of Pseudomonas aeruginosa.
abstract: BACKGROUND
  A group of patients who harbour the same highly transmissible strain of Pseudomonas aeruginosa were identified at a cystic fibrosis (CF) centre. Isolates of this strain display a number of unusual phenotypic features including resistance to most typical antipseudomonal antibiotics. A study was undertaken to see if there was a difference in treatment requirements between CF patients with chronic infection with their own unique P aeruginosa strains (group 1) and those who harbour a highly transmissible strain (group 2).
  
  
  METHODS
  Data on treatment requirements for the year 2000 were collected from the case records of CF patients with chronic P aeruginosa infection who had received inpatient treatment. Patients co-infected with Burkholderia cepacia or other highly transmissible strains of P aeruginosa were excluded.
  
  
  RESULTS
  There were 2/56 and 3/22 deaths in groups 1 and 2, respectively; these patients were excluded from the analysis. No difference was found between the two groups for mean age, % predicted forced expiratory volume in 1 second (FEV(1)), % predicted forced vital capacity (FVC), and body mass index. Patients in group 2 had a greater median (range) number of intravenous antibiotic days (60 (17-216) v 33 (4-237) days; p=0.01), inpatient days (39 (7-183) v 16 (1-172) days; p<0.01), and inpatient episodes (3 (1-9) v 2 (1-6); p<0.01), and more respiratory exacerbations (mean (SD) 8.2 (3.4) v 6.1 (3.2); p=0.01).
  
  
  CONCLUSIONS
  Patients who harbour the highly transmissible P aeruginosa strain have a greater treatment burden than patients with CF who harbour their own unique strains. These findings support the need for microbiological surveillance for highly transmissible P aeruginosa and the implementation of infection control measures to prevent cross infection.
authors.affiliation: Bradbury Cystic Fibrosis Unit, South Manchester NHS Trust, Wythenshawe Hospital, Manchester M23 9LT, UK. andmarkj@hotmail.com
authors.forename: A M
authors.initials: AM
authors.lastname: Jones
authors.forename: M E
authors.initials: ME
authors.lastname: Dodd
authors.forename: C J
authors.initials: CJ
authors.lastname: Doherty
authors.forename: J R W
authors.initials: JR
authors.lastname: Govan
authors.forename: A K
authors.initials: AK
authors.lastname: Webb
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000382:microbiology*; D003550:Cystic Fibrosis / Q000382:microbiology* / Q000503:physiopathology; D004351:Drug Resistance; D018432:Drug Resistance, Multiple; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000503:physiopathology; D011550:Pseudomonas aeruginosa; D014797:Vital Capacity / Q000502:physiology