title: Increased Prevalence and Resistance of Important Pathogens Recovered from Respiratory Specimens of Cystic Fibrosis Patients During a Decade.
abstract: BACKGROUND
  The study objective was to identify changes of prevalence and resistance of important pathogens in specimens of cystic fibrosis (CF) patients within a decade.
  
  
  METHODS
  Samples of 94 patients, who attended 2 CF centers from 2001 to 2011 were retrospectively analyzed.
  
  
  RESULTS
  Staphylococcus aureus was the most prevalent organism (74.5% in 2011) with an increase of methicillin-resistant S. aureus in patients (0% vs. 9.6%, n = 9). Resistance of S. aureus to gentamicin decreased (41.8% vs. 21%; P < 0.001), whereas resistance to rifampicin and trimethoprim/sulfamethoxazole (P < 0.05) increased significantly with a trend to increased resistance to clindamycin and erythromycin (P = 0.063). Methicillin-resistant S. aureus isolates belonged to 6 spa types (t003, t008, t011, t034, t045, t548). There was a significant increase of Pseudomonas aeruginosa prevalence (63.8% in 2011 vs. 46.8% in 2001, P = 0.019). Resistance of P. aeruginosa increased significantly to imipenem, gentamicin, amikacin, tobramycin, ciprofloxacin and fosfomycin, whereas resistance to piperacillin-tazobactam, meropenem and aztreonam decreased. Significantly fewer Stenotrophomonas maltophilia isolates were susceptible to all the analyzed antibiotics (trimethoprim/sulfamethoxazole, ciprofloxacin and colistin) in 2011 compared with 2001 (13.5% vs. 42.1%; P = 0.023), whereas the resistance to colistin increased significantly (11.1% vs. 62.2%; P < 0.001). Burkholderia cepacia complex and nontuberculous mycobacteria were not detected in 2001 but in 2011 in 7.4% (n = 9) and 7.4% (n = 9) of patients, respectively. B. cepacia complex isolates belonged to 8 multilocus sequence types.
  
  
  CONCLUSIONS
  Our retrospective analysis revealed an increase of important CF-related pathogens, the emergence of new pathogens and a substantial increase of multidrug-resistant CF-specific isolates. Our findings are of importance to clinicians for the alertness of local epidemiology, which may be useful for prevention and treatment strategies.
authors: From the *Institute of Medical Microbiology, and †Department of Pediatrics, University Hospital Münster, Münster, Germany; ‡Department of Pediatrics, Clemenshospital Münster, Münster, Germany; and §Department of Medical Microbiology, University Hospital Motol, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Lena
authors: L
authors: Raidt
authors: Evgeny A
authors: EA
authors: Idelevich
authors: Angelika
authors: A
authors: Dübbers
authors: Peter
authors: P
authors: Küster
authors: Pavel
authors: P
authors: Drevinek
authors: Georg
authors: G
authors: Peters
authors: Barbara C
authors: BC
authors: Kahl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D012189:Retrospective Studies; D055815:Young Adult