title: Molecular epidemiology of chronic Pseudomonas aeruginosa airway infections in cystic fibrosis.
abstract: METHODS
  The molecular epidemiology of the chronic airway infections with Pseudomonas aeruginosa in individuals with cystic fibrosis (CF) was investigated by cross-sectional analysis of bacterial isolates from 51 CF centers and by longitudinal analysis of serial isolates which had been collected at the CF centers Hanover and Copenhagen since the onset of airway colonization over 30 years.
  
  
  RESULTS
  Genotyping revealed that the P. aeruginosa population in CF is dominated by a few ubiquitous clones. The five most common clones retrieved from the CF host also belonged to the twenty most frequent clones in the environment and in other human disease habitats. Turnover of clones in CF airways was rare. At the Hanover clinic more than half of the patient cohort was still harbouring the initially acquired clone after twenty years of airway colonization. At the Copenhagen clinic, however, two rare clones replaced the initially acquired individual clones in all but one patient.
  
  
  CONCLUSIONS
  The divergent epidemiology at the two sites is explained by their differential management of hygiene and antipseudomonal chemotherapy. Hygienic measures to prohibit patient-to-patient transmission and the modalities of antipseudomonal chemotherapy modify the epidemiology of the chronic P. aeruginosa infections in CF.
authors.affiliation: Clinical Research Group, Clinic for Pediatric Pneumology, Allergology and Neonatology, Hanover Medical School, Hanover, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Cramer
authors.forename: Lutz
authors.initials: L
authors.lastname: Wiehlmann
authors.forename: Oana
authors.initials: O
authors.lastname: Ciofu
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tamm
authors.forename: Niels
authors.initials: N
authors.lastname: Høiby
authors.forename: Burkhard
authors.initials: B
authors.lastname: Tümmler
mesh_terms: D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000382:microbiology*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology / Q000379:methods*; D011552:Pseudomonas Infections / Q000453:epidemiology* / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000235:genetics*