Pathogen characteristics reveal novel antibacterial approaches for interstitial lung disease.
Interstitial lung disease (ILD) is a clinical disorder associated with changes of lung structure. Concurrent infection is a serious complication and one of the major factors that exacerbates ILD. Pathogen screening is a critical step in early diagnosis and proper treatment of ILD with secondary infection. Here we analyzed distribution and drug susceptibility of pathogens isolated from hospitalized ILD patients from January, 2007 to December, 2008 and compared them to bacterial drug resistance data in CHINET during the same period. The main specimens were from sputum culture, lavage fluid culture, lung biopsy tissue culture, and pleural effusion culture and bacterial or fungal cultures were performed on these specimens accordingly. Drug susceptibility was tested for positive bacterial cultures using disk diffusion (Kirby-Bauer method) and E Test strips in which results were determined based on the criteria of CLSI (2007). A total of 371 pathogen strains from ILD patients, including 306 bacterial strains and 65 fungal strains were isolated and cultured. Five main bacterial strains and their distribution were as follows: Klebsiella pneumoniae (31.7%), Pseudomonas aeruginosa (20.6%), Acinetobacter (12.7%), Enterobacter cloacae (8.2%), and Staphylococcus aureus (7.8%). The results showed that ILD patients who had anti-infection treatment tended to have Gram-negative bacteria, whether they acquired an infection in the hospital or elsewhere. Drug resistance screening indicated that aminoglycosides and carbapenems had lower antibiotic resistance rates. In addition, we found that the usage of immunosuppressants was associated with the increased infection rate and number of pathogens that were isolated. In conclusion, aminoglycosides and carbapenems may be selected as a priority for secondary infection to control ILD progression. Meanwhile, the use of anti-MRSA/MRCNS drugs may be considered for Staphylococcus infection.
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Hai-Wen
HW
Lu
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Xiao-Bin
XB
Ji
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Shuo
S
Liang
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Li-Chao
LC
Fan
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Jiu-Wu
JW
Bai
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Ke-Bing
KB
Chen
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Yin
Y
Zhou
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China.
Hui-Ping
HP
Li
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 200433 Shanghai, China. Electronic address: jfxucn@gmail.com.
Jin-Fu
JF
Xu
D000150:Acinetobacter / Q000187:drug effects; D000151:Acinetobacter Infections / Q000188:drug therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D013183:Sputum / Q000382:microbiology
D000900:Anti-Bacterial Agents
Bacteria; CHINET; Fungi; Infection; Interstitial lung disease (ILD); Resistance surveillance