Clinical profile of adult cystic fibrosis patients with frequent epidemic clones of Pseudomonas aeruginosa

Background and objective:  Earlier reports suggested that Pseudomonas aeruginosa frequent epidemic clones circulating in cystic fibrosis (CF) centres had increased virulence. However, recent data show no consistent associations with virulence, and suggest attenuation of virulence in chronic infection. Changes to infection control programmes in relation to frequent epidemic clones should be based on their frequency, virulence across all age groups and mode of acquisition. The Australian epidemic strain‐1 (AES‐1) (or the Melbourne epidemic strain) and AES‐2 are common in CF clinics in mainland eastern Australia, but not in the environment. Both have shown increased virulence, but there are no data specifically in adults. This study examines the frequency and virulence of P. aeruginosa frequent epidemic clones in the adult CF clinic at Royal Prince Alfred Hospital, Sydney, Australia.

[1]  Bruno Pot,et al.  Pseudomonas aeruginosa Population Structure Revisited , 2009, PloS one.

[2]  A. Champion,et al.  Poor clinical outcomes associated with a multi‐drug resistant clonal strain of Pseudomonas aeruginosa in the Tasmanian cystic fibrosis population , 2008, Respirology.

[3]  Christian Weinel,et al.  Population structure of Pseudomonas aeruginosa , 2007, Proceedings of the National Academy of Sciences.

[4]  Lucas Smith,et al.  Phenotypic Characterization of Clonal and Nonclonal Pseudomonas aeruginosa Strains Isolated from Lungs of Adults with Cystic Fibrosis , 2007, Journal of Clinical Microbiology.

[5]  Lars Jelsbak,et al.  Molecular Epidemiology and Dynamics of Pseudomonas aeruginosa Populations in Lungs of Cystic Fibrosis Patients , 2007, Infection and Immunity.

[6]  M. Elkins,et al.  Protease IV production in Pseudomonas aeruginosa from the lungs of adults with cystic fibrosis. , 2006, Journal of medical microbiology.

[7]  David A. D'Argenio,et al.  Genetic adaptation by Pseudomonas aeruginosa to the airways of cystic fibrosis patients. , 2006, Proceedings of the National Academy of Sciences of the United States of America.

[8]  T. Pitt,et al.  Factors associated with infection by Pseudomonas aeruginosa in adult cystic fibrosis , 2005, European Respiratory Journal.

[9]  R. Geffers,et al.  A Cystic Fibrosis Epidemic Strain of Pseudomonas aeruginosa Displays Enhanced Virulence and Antimicrobial Resistance , 2005, Journal of bacteriology.

[10]  M. Dodd,et al.  Prospective surveillance for Pseudomonas aeruginosa cross-infection at a cystic fibrosis center. , 2005, American journal of respiratory and critical care medicine.

[11]  S. Bell,et al.  Clonal strains of Pseudomonas aeruginosa in paediatric and adult cystic fibrosis units , 2004, European Respiratory Journal.

[12]  T. Pitt,et al.  Identification and characterization of transmissible Pseudomonas aeruginosa strains in cystic fibrosis patients in England and Wales. , 2004, Journal of medical microbiology.

[13]  C. Hart,et al.  Increased morbidity associated with chronic infection by an epidemic Pseudomonas aeruginosa strain in CF patients , 2004, Thorax.

[14]  Colin Harbour,et al.  Evidence for Spread of a Clonal Strain of Pseudomonas aeruginosa among Cystic Fibrosis Clinics , 2003, Journal of Clinical Microbiology.

[15]  M. Dodd,et al.  Increased treatment requirements of patients with cystic fibrosis who harbour a highly transmissible strain of Pseudomonas aeruginosa , 2002, Thorax.

[16]  J. Carlin,et al.  Detection of a widespread clone of Pseudomonas aeruginosa in a pediatric cystic fibrosis clinic. , 2002, American journal of respiratory and critical care medicine.

[17]  M. Elkins,et al.  Genetic Analysis of Pseudomonas aeruginosa Isolates from the Sputa of Australian Adult Cystic Fibrosis Patients , 2002, Journal of Clinical Microbiology.

[18]  M. Dodd,et al.  Spread of a multiresistant strain of Pseudomonas aeruginosa in an adult cystic fibrosis clinic , 2001, The Lancet.

[19]  J. Carlin,et al.  Clinical outcome after early Pseudomonas aeruginosa infection in cystic fibrosis. , 2001, The Journal of pediatrics.

[20]  N. Høiby,et al.  Typing of Pseudomonas aeruginosa strains in Norwegian cystic fibrosis patients. , 2001, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[21]  J. Raboud,et al.  Burkholderia cepacia in cystic fibrosis. Variable disease course. , 1999, American journal of respiratory and critical care medicine.

[22]  M. Denton,et al.  Spread of β-lactam-resistant Pseudomonas aeruginosa in a cystic fibrosis clinic , 1996 .

[23]  C. Winstanley,et al.  Spread of beta-lactam-resistant Pseudomonas aeruginosa in a cystic fibrosis clinic. , 1996, Lancet.

[24]  D H Persing,et al.  Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing , 1995, Journal of clinical microbiology.

[25]  J. Lipuma,et al.  Burkholderia cepacia in cystic fibrosis. , 1995, The New England journal of medicine.

[26]  H. Fuchs,et al.  Effect of aerosolized recombinant human DNase on exacerbations of respiratory symptoms and on pulmonary function in patients with cystic fibrosis. The Pulmozyme Study Group. , 1994, The New England journal of medicine.

[27]  B. Tümmler,et al.  A major Pseudomonas aeruginosa clone common to patients and aquatic habitats , 1994, Applied and environmental microbiology.

[28]  J E Cotes,et al.  Lung volumes and forced ventilatory flows , 1993, European Respiratory Journal.