title: Phenotypic & genotypic variants of Pseudomonas aeruginosa isolated from children with cystic fibrosis in India.
abstract: OBJECTIVE
  Pseudomonas aeruginosa is the leading cause of morbidity and mortality in patients with cystic fibrosis (CF). With increase in the chronicity of the disease, there is a diversification of the organism into different colony morphological types. The antimicrobial susceptibility of the organism varies with its colony morphology. The present work was carried out to study the different morphotypes of P. aeruginosa isolated from patients of cystic fibrosis.
  
  
  METHODS
  We studied 38 children with CF attending the Paediatric Chest Clinic at the All India Institute of Medical Sciences, New Delhi, India during October 2000-January 2001 who were regularly followed up at the clinic. Patients were divided into 2 groups, Group 1 included all patients chronically infected with P. aeruginosa and Group 2 included patients who were infrequently colonized with this organism. Different colony morphological types of P. aeruginosa on culture media were identified. They were characterized by phenotypic methods using antibiograms and genotypic methods using enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction and PCR-ribotyping.
  
  
  RESULTS
  Fourteen of the 38 patients were colonized at least once with P. aeruginosa. Eight patients belonged to Group 1 and 42 isolates were obtained from these patients. Group 2 had 6 patients and 9 isolates were obtained from them. All patients in Group 1 harboured different colony morphotypes (Types 1-6) while all 6 patients in Group 2 showed a single type of colony morphology (Type 1). The isolates from Group 1 patients showed higher antimicrobial resistance as compared to Group 2 patients. Molecular typing of the isolates revealed 10 ERIC-PCR patterns and 2 PCR-ribotyping patterns among Group 1 and 2 ERIC-PCR and 1 PCR-ribotyping pattern among patients of Group 2.
  
  
  CONCLUSIONS
  The frequency of different morphotypes of P. aeruginosa and antibiotic resistance was higher among Group 1 patients. On molecular typing, more than one genotype was isolated from Group 1 patients while only one genotype was isolated from patients in Group 2. We conclude that at a given time, chronically infected patients can be colonized by phenotypically and genotypically distinct strains of P. aeruginosa which has an implication in the management of these patients.
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Gunjan
authors.initials: G
authors.lastname: Agarwal
authors.forename: Arti
authors.initials: A
authors.lastname: Kapil
authors.forename: S K
authors.initials: SK
authors.lastname: Kabra
authors.forename: Rachna
authors.initials: R
authors.lastname: Chandra
authors.forename: Bimal
authors.initials: B
authors.lastname: Das
authors.forename: S N
authors.initials: SN
authors.lastname: Diwedi
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D005260:Female; D005838:Genotype; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D010641:Phenotype; D016133:Polymerase Chain Reaction / Q000379:methods; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D011550:Pseudomonas aeruginosa / Q000235:genetics* / Q000302:isolation & purification; D013183:Sputum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents