title: Recurrent Pseudomonas aeruginosa Infection in Chronic Lung Diseases: Relapse or Reinfection?
abstract: BACKGROUND
  Pseudomonas aeruginosa infection is particularly associated with progressive and ultimately chronic recurrent respiratory infections in chronic obstructive pulmonary disease, bronchiectasis, chronic destroyed lung disease, and cystic fibrosis. Its treatment is also very complex because of drug resistance and recurrence.
  
  
  METHODS
  Forty eight cultures from 18 patients with recurrent P. aeruginosa pneumonia from 1998 to 2002 were included in this study. Two or more pairs of sputum cultures were performed during 2 or more different periods of recurrences. The comparison of strains was made according to the phenotypic patterns of antibiotic resistance and chromosomal fingerprinting by pulsed field gel electrophoresis (PFGE) using the genomic DNA of P. aeruginosa from the sputum culture.
  
  
  RESULTS
  Phenotypic patterns of antibiotic resistance of P. aeruginosa were not correlated with their prior antibiotic exposition. Fifteen of 18 patients (83.3%) had recurrent P. aeruginosa pneumonia caused by the strains with same PFGE pattern.
  
  
  CONCLUSIONS
  These data suggest that the most of the recurrent P. aeruginosa infections in chronic lung disease occurred due to the relapse of prior infections. Further investigations should be performed for assessing the molecular mechanisms of the persistent colonization and for determining how to eradicate clonal persistence of P. aeruginosa.
authors.affiliation: Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
authors.forename: Ho-Kee
authors.initials: HK
authors.lastname: Yum
authors.affiliation: Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
authors.forename: I-Nae
authors.initials: IN
authors.lastname: Park
authors.affiliation: Department of Laboratory Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Bo-Mun
authors.initials: BM
authors.lastname: Shin
authors.affiliation: Department of Laboratory Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Soo-Jeon
authors.initials: SJ
authors.lastname: Choi
keywords: Electrophoresis, Gel, Pulsed-Field; Pneumonia; Pseudomonas aeruginosa