title: Reinfection, rather than persistent infection, in patients with chronic granulomatous disease.
abstract: Chronic granulomatous disease (CGD) is characterized by severe recurrent infections with Staphylococcus aureus, certain gram-negative rods, Nocardia species, and fungi. When infections with the same species recur, they may represent relapses or new infections. We collected organisms from infections that occurred between 1992 and 2000 in patients with CGD and determined the biochemical phenotypes, in vitro antibiotic susceptibility patterns, and pulsed-field gel electrophoresis (PFGE) patterns of the organisms causing the initial and recurrent infections. Recurrence of infection with Burkholderia cepacia or Serratia marcescens was caused by a new strain in 9 of 10 cases (P=.001). Recurrent S. aureus infections were caused by new strains in 7 of 8 cases (P=.006). In patients with CGD, recurrence of infection with the same bacterial species after appropriate antibiotic therapy usually represents new infection.
authors.affiliation: Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases and Clinical Research Training Program/NIH, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: Shireen V
authors.initials: SV
authors.lastname: Guide
authors.forename: Frida
authors.initials: F
authors.lastname: Stock
authors.forename: Vee J
authors.initials: VJ
authors.lastname: Gill
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Anderson
authors.forename: Harry L
authors.initials: HL
authors.lastname: Malech
authors.forename: John I
authors.initials: JI
authors.lastname: Gallin
authors.forename: Steven M
authors.initials: SM
authors.lastname: Holland
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D019121:Burkholderia Infections / Q000382:microbiology; D016956:Burkholderia cepacia / Q000145:classification / Q000187:drug effects / Q000235:genetics; D002648:Child; D016521:Electrophoresis, Gel, Pulsed-Field; D006105:Granulomatous Disease, Chronic / Q000150:complications*; D006801:Humans; D008100:Liver Abscess / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D012008:Recurrence; D016868:Serratia Infections / Q000382:microbiology; D012706:Serratia marcescens / Q000145:classification / Q000187:drug effects / Q000235:genetics; D013203:Staphylococcal Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents