Application of quantitative PCR to the diagnosis and monitoring of Pseudomonas aeruginosa colonization in 5-18-year-old cystic fibrosis patients.
Early detection of Pseudomonas aeruginosa and early aggressive treatment are recommended to delay chronic infection in cystic fibrosis (CF) patients. The aim of this study was to assess a quantitative PCR (q-PCR) assay for the diagnosis of early P. aeruginosa colonization in 23 young CF patients (group A, age range 7-18 years) and to survey the eradication of P. aeruginosa in 10 young CF patients (group B, age range 5-18 years) after an initial antibiotic treatment. q-PCR results for consecutive sputum samples from each patient during a period of 18 months were compared with bacterial cultures during the same period plus an additional period of 12 months, and with concomitant clinical signs of pulmonary exacerbation. The q-PCR and bacterial cultures were negative for 17 of the 23 patients in group A and six of the 10 patients in group B during the study period. However, consecutive positive q-PCR results were observed for one patient in group A and three patients in group B, while the bacterial cultures for the same sputum sample remained negative. They preceded positive P. aeruginosa bacterial cultures at 7 and 8 months for two patients in group B. These positive results were associated with a worsening of the clinical status of patients, but pulmonary exacerbation appeared non-specific for the diagnosis of early P. aeruginosa colonization since pulmonary exacerbations were observed in patients in whom q-PCR or bacterial culture remained negative. In conclusion, q-PCR may be a useful additional tool to provide information on the P. aeruginosa status of CF patients.
Department of Microbiology, Lille University Hospital, Lille, France.
Typhaine
T
Billard-Pomares
Department of Microbiology, Lille University Hospital, Lille, France.
Stéphanie
S
Herwegh
Cystic Fibrosis Center, Department of Pediatrics, Jeanne de Flandre Lille University Children's Hospital, Lille, France.
Nathalie
N
Wizla-Derambure
Inserm 995 Unit, IFR 114, Lille Nord de France University, Lille, France.|Cystic Fibrosis Center, Department of Pediatrics, Jeanne de Flandre Lille University Children's Hospital, Lille, France.
Dominique
D
Turck
Department of Microbiology, Lille University Hospital, Lille, France.
René
R
Courcol
Inserm 995 Unit, IFR 114, Lille Nord de France University, Lille, France.|Cystic Fibrosis Center, Department of Pediatrics, Jeanne de Flandre Lille University Children's Hospital, Lille, France.|Department of Microbiology, Lille University Hospital, Lille, France.
Marie-Odile
MO
Husson
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001431:Bacteriological Techniques / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods*; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology; D013997:Time Factors
D000900:Anti-Bacterial Agents