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Prevalence of antibiotic resistance of Pseudomonas aeruginosa in cystic fibrosis infection: A systematic review and meta-analysis. Microb Pathog 2022; 165:105461. [DOI: 10.1016/j.micpath.2022.105461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/16/2022]
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2
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Influenza B outbreak at an adult cystic fibrosis centre - Clinical impact and factors influencing spread. J Cyst Fibros 2020; 19:808-814. [DOI: 10.1016/j.jcf.2020.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/03/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022]
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Bell SC, Armstrong D, Harrington G, Jardine L, Divakaran R, Loff B, Middleton PG, McDonald T, Rowland K, Wishart M, Wood ME, Stuart RL. Work environment risks for health care workers with cystic fibrosis. Respirology 2018; 23:1190-1197. [PMID: 30215873 DOI: 10.1111/resp.13404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/22/2018] [Accepted: 08/21/2018] [Indexed: 01/06/2023]
Abstract
In Australia and New Zealand, >50% of people with cystic fibrosis (CF) are adults and many of these people are pursuing vocational training and undertaking paid employment. More than 6% of adults with CF are working in health care. There is limited guidance in literature to support health care workers with CF (HCWcf) in training and in employment to support safe practice and to provide protection for themselves and their patients from the acquisition of health care associated infection. A multidisciplinary team of CF and Infectious Disease Clinicians, Infection Prevention and Control Practitioners, HCWcf, academic experts in medical ethics and representatives from universities, appraised the available evidence on the risk posed to and by HCWcf. Specific recommendations were made for HCWcf, CF health care teams, hospitals and universities to support the safe practice and appropriate support for HCWcf.
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Affiliation(s)
- Scott C Bell
- Department of Thoracic Medicine, Adult Cystic Fibrosis Centre, The Prince Charles Hospital and QIMR Berghofer Medicine Research Institute, Brisbane, QLD, Australia
| | - David Armstrong
- Monash Children's Cystic Fibrosis Centre, Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | | | - Luke Jardine
- Department of Neonatology, Mater Mothers' Hospital, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - Bebe Loff
- Michael Kirby Centre for Public Health and Human Rights, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Peter G Middleton
- Department Respiratory and Sleep Medicine, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
| | - Tim McDonald
- Department of Paediatrics, Canberra Hospital, Canberra, ACT, Australia
| | - Karen Rowland
- Department of Infectious Disease, Calvary Hospital, Adelaide, SA, Australia
| | - Michael Wishart
- Department of Infection Control and Prevention, Holy Spirit Northside, Brisbane, QLD, Australia
| | - Michelle E Wood
- Department of Physiotherapy and Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Rhonda L Stuart
- Department of Infectious Diseases, Monash Health, Melbourne, VIC, Australia
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Pereira RPA, Peplies J, Mushi D, Brettar I, Höfle MG. Pseudomonas-Specific NGS Assay Provides Insight Into Abundance and Dynamics of Pseudomonas Species Including P. aeruginosa in a Cooling Tower. Front Microbiol 2018; 9:1958. [PMID: 30186269 PMCID: PMC6110898 DOI: 10.3389/fmicb.2018.01958] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 08/02/2018] [Indexed: 12/23/2022] Open
Abstract
Pseudomonas species are frequent inhabitants of freshwater environments and colonizers of water supply networks via bioadhesion and biofilm formation. P. aeruginosa is the species most commonly associated with human disease, causing a wide variety of infections with links to its presence in freshwater systems. Though several other Pseudomonas species are of ecological and public health importance, little knowledge exists regarding environmental abundances of these species. In the present study, an Illumina-based next-generation sequencing (NGS) approach using Pseudomonas-specific primers targeting the 16S rRNA gene was evaluated and applied to a set of freshwater samples from different environments including a cooling tower sampled monthly during 2 years. Our approach showed high in situ specificity and accuracy. NGS read counts revealed a precise quantification of P. aeruginosa and a good correlation with the absolute number of Pseudomonas genome copies in a validated genus-specific qPCR assay, demonstrating the ability of the NGS approach to determine both relative and absolute abundances of Pseudomonas species and P. aeruginosa. The characterization of Pseudomonas communities in cooling tower water allowed us to identify 43 phylotypes, with P. aeruginosa being the most abundant. A shift existed within each year from a community dominated by phylotypes belonging to P. fluorescens and P. oleovorans phylogenetic groups to a community where P. aeruginosa was highly abundant. Co-occurrence was observed between P. aeruginosa and other phylotypes of P. aeruginosa group as well as the potentially pathogenic species P. stutzeri, but not with phylotypes of the P. fluorescens group, indicating the need to further investigate the metabolic networks and ecological traits of Pseudomonas species. This study demonstrates the potential of deep sequencing as a valuable tool in environmental diagnostics and surveillance of health-related pathogens in freshwater environments.
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Affiliation(s)
- Rui P A Pereira
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Douglas Mushi
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.,Department of Biological Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Ingrid Brettar
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Manfred G Höfle
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
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Finch S, Keir HR, Dicker AJ, Chalmers JD. The past decade in bench research into pulmonary infectious diseases: What do clinicians need to know? Respirology 2017; 22:1062-1072. [PMID: 28657170 DOI: 10.1111/resp.13106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/07/2017] [Accepted: 05/14/2017] [Indexed: 12/12/2022]
Abstract
Respiratory infections are primarily treated with antibiotics, drugs that are mostly inexpensive and have been widely available since the 1940s and 1950s. Nevertheless, despite antibiotics, the burden of disease in pneumonia, bronchiectasis, cystic fibrosis, COPD and rare respiratory infections remains exceptionally high. There is an urgent need for translational studies to develop new treatments or new biomarkers to improve outcomes in these conditions. The 'translational gaps' between bench science and clinical practice are particularly challenging in respiratory infections. This is partly due to the poor representativeness of animal models of infection to human disease, and a long-term lack of investment into pulmonary infection research. The revolution in genomics and other omics technologies, however, is beginning to unlock clinically important information about the host response to infection, the behaviour of bacterial communities and the development of new antibiotics. It is not possible to review the extensive progress made in the last decade into the pathophysiology of the different respiratory infections and so here, we focus on major technologies that are now changing respiratory infection research, specifically bacterial whole-genome sequencing, the microbiota, personalized medicine with omics technologies, new antibiotic development and host inflammatory cell biology.
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Affiliation(s)
- Simon Finch
- Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Holly R Keir
- Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Alison J Dicker
- Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - James D Chalmers
- Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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Damron FH, Goldberg JB. Proteolytic regulation of alginate overproduction in Pseudomonas aeruginosa. Mol Microbiol 2012; 84:595-607. [PMID: 22497280 DOI: 10.1111/j.1365-2958.2012.08049.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Pseudomonas aeruginosa, a Gram-negative bacterium, is a significant opportunistic pathogen associated with skin and soft tissue infections, nosocomial pneumonia and sepsis. In addition, it can chronically colonize the lungs of cystic fibrosis (CF) patients. Overproduction of the exopolysaccharide called alginate provides P. aeruginosa with a selective advantage and facilitates survival in the CF lung. The in vitro phenotype of alginate overproduction observed on solid culture media is referred to as mucoid. Expression of the alginate machinery and biosynthetic enzymes are controlled by the extracytoplasmic sigma factor, σ(22) (AlgU/T). The key negative regulator of both σ(22) activity and the mucoid phenotype is the cognate anti-sigma factor MucA. MucA sequesters σ(22) to the inner membrane inhibiting the sigma factor's transcriptional activity. The well-studied mechanism for transition to the mucoid phenotype is mutation of mucA, leading to loss of MucA function and therefore activation of σ(22) . Recently, regulated intramembrane proteolysis (RIP) has been recognized as a mechanism whereby proteolysis of the anti-sigma factor MucA leads to active σ(22) allowing P. aeruginosa to respond to environmental stress conditions by overproduction of alginate. The goal of this review is to illuminate the pathways leading to RIP that have been identified and proposed.
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Affiliation(s)
- F Heath Damron
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia Health System, Charlottesville, VA, USA
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Wiehlmann L, Cramer N, Ulrich J, Hedtfeld S, Weißbrodt H, Tümmler B. Effective prevention of Pseudomonas aeruginosa cross-infection at a cystic fibrosis centre – Results of a 10-year prospective study. Int J Med Microbiol 2012; 302:69-77. [DOI: 10.1016/j.ijmm.2011.11.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 11/04/2011] [Accepted: 11/06/2011] [Indexed: 11/28/2022] Open
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van Mansfeld R, Jongerden I, Bootsma M, Buiting A, Bonten M, Willems R. The population genetics of Pseudomonas aeruginosa isolates from different patient populations exhibits high-level host specificity. PLoS One 2010; 5:e13482. [PMID: 20976062 PMCID: PMC2957436 DOI: 10.1371/journal.pone.0013482] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 08/31/2010] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To determine whether highly prevalent P. aeruginosa sequence types (ST) in Dutch cystic fibrosis (CF) patients are specifically linked to CF patients we investigated the population structure of P. aeruginosa from different clinical backgrounds. We first selected the optimal genotyping method by comparing pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and multilocus variable number tandem-repeat analysis (MLVA). METHODS Selected P. aeruginosa isolates (n = 60) were genotyped with PFGE, MLST and MLVA to determine the diversity index (DI) and congruence (adjusted Rand and Wallace coefficients). Subsequently, isolates from patients admitted to two different ICUs (n = 205), from CF patients (n = 100) and from non-ICU, non-CF patients (n = 58, of which 19 were community acquired) were genotyped with MLVA to determine distribution of genotypes and genetic diversity. RESULTS Congruence between the typing methods was >79% and DIs were similar and all >0.963. Based on costs, ease, speed and possibilities to compare results between labs an adapted MLVA scheme called MLVA9-Utrecht was selected as the preferred typing method. In 363 clinical isolates 252 different MLVA types (MTs) were identified, indicating a highly diverse population (DI = 0.995; CI = 0.993-0.997). DI levels were similarly high in the diverse clinical sources (all >0.981) and only eight genotypes were shared. MTs were highly specific (>80%) for the different patient populations, even for similar patient groups (ICU patients) in two distinct geographic regions, with only three of 142 ICU genotypes detected in both ICUs. The two major CF clones were unique to CF patients. CONCLUSION The population structure of P. aeruginosa isolates is highly diverse and population specific without evidence for a core lineage in which major CF, hospital or community clones co-cluster. The two genotypes highly prevalent among Dutch CF patients appeared unique to CF patients, suggesting specific adaptation of these clones to the CF lung.
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Affiliation(s)
- Rosa van Mansfeld
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
- * E-mail:
| | - Irene Jongerden
- Department of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Martin Bootsma
- Julius Center for Health Research and Primary Care, University Medical Centre Utrecht, and Department of Mathematics, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Anton Buiting
- Department of Medical Microbiology and Immunology, St Elisabeth Hospital, Tilburg, The Netherlands
| | - Marc Bonten
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Rob Willems
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Abbott J. Health-related quality of life measurement in cystic fibrosis: advances and limitations. Chron Respir Dis 2009; 6:31-41. [PMID: 19176710 DOI: 10.1177/1479972308098159] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Health-related quality of life (HRQoL) measurement in cystic fibrosis (CF) allows the inclusion of the patient's perspective in research and clinical practice. HRQoL scales have been used for many purposes and this review focuses on how HRQoL measurement has been implemented in CF research and care. Specifically, the review considers 1) the instruments used to measure HRQoL, 2) the factors that influence how people report HRQoL, 3) the monitoring of HRQoL in clinical practice, 4) HRQoL as an outcome measure in interventions and clinical trials and 5) whether HRQoL can predict survival. The challenge for the future is to use the available information to develop and evaluate psychological interventions that would be expected to improve HRQoL in children and adults with CF.
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Affiliation(s)
- J Abbott
- Faculty of Health, University of Central Lancashire, Preston, Lancashire, UK.
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Waine DJ, Whitehouse J, Honeybourne D. Cross-infection in cystic fibrosis: The knowledge and behaviour of adult patients. J Cyst Fibros 2007; 6:262-6. [PMID: 17141578 DOI: 10.1016/j.jcf.2006.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Revised: 09/20/2006] [Accepted: 10/18/2006] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The knowledge and behaviour of adult patients with cystic fibrosis (CF) regarding cross-infection are ill understood. METHODS A questionnaire was designed to investigate this at the West Midlands Adult CF Centre. RESULTS 94 patients completed the questionnaire. 54%, 36% and 46% had "no idea" of the lifetime risk of contracting Burkholderia cepacia complex, epidemic strains of Pseudomonas aeruginosa, and MRSA, respectively. 25-33% did not know the consequences of infection with these bacteria. 35% mixed with other people with CF, 6.5% during physiotherapy or nebulizer use. Most respondents did not think quality of life was significantly linked with segregation from other patients with CF. CONCLUSIONS Adults with CF, at least in the West Midlands, have poor knowledge of the risk and consequences of cross-infection. A significant proportion ignored advice not to mix with other patients, although segregation was not thought to impact upon quality of life. This suggests that more education about the risks of cross-infection would be beneficial.
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Affiliation(s)
- David J Waine
- West Midlands Adult CF Unit, Heart of England Foundation Trust, Bordesley Green East, Birmingham, UK.
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Lewis DA, Jones A, Parkhill J, Speert DP, Govan JRW, Lipuma JJ, Lory S, Webb AK, Mahenthiralingam E. Identification of DNA markers for a transmissible Pseudomonas aeruginosa cystic fibrosis strain. Am J Respir Cell Mol Biol 2005; 33:56-64. [PMID: 15834046 DOI: 10.1165/rcmb.2004-0352oc] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A number of transmissible Pseudomonas aeruginosa strains have been identified which potentially constitute an emerging threat to patients with cystic fibrosis (CF). We sought to identify DNA markers that were specific to a transmissible P. aeruginosa CF clone and evaluate these probes on a large collection of genotypically distinct P. aeruginosa strains. Using subtractive DNA hybridization, in combination with analysis using the P. aeruginosa PAO1 genome chip, DNA markers specific for or absent from the Manchester transmissible CF strain (MA) were identified. Five subtractive DNA hybridization markers (MA15, MA18, MA21, MA22, and MA30) were found to be specific to strain MA and were located within a novel 13,318-bp genomic island, designated the MA island. The MA island encoded 18 genes and consisted of two bacteriophage-like regions; one region encoded the MA-specific subtractive hybridization markers, while the other bacteriophage-like region contained a Vibrio cholera-like toxin gene. Probes MA15, MA18, MA21, MA22, and MA30 were all found to be specific to strain MA when a collection of 141 P. aeruginosa strains was examined by hybridization with each DNA marker. In contrast, a previously isolated DNA marker for the Liverpool transmissible CF strain, PS21, was not found to be specific, detecting two additional strain types in the collection screened. Both the Manchester and Liverpool strain types were not encountered in CF populations outside the United Kingdom. The MA genomic island and Vibrio cholera-like toxin gene within it constitute novel genetic factors associated with a transmissible P. aeruginosa strain and their role in pathogenesis remains to be determined.
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Döring G, Hoiby N. Early intervention and prevention of lung disease in cystic fibrosis: a European consensus. J Cyst Fibros 2004; 3:67-91. [PMID: 15463891 DOI: 10.1016/j.jcf.2004.03.008] [Citation(s) in RCA: 193] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2004] [Accepted: 03/24/2004] [Indexed: 10/26/2022]
Abstract
In patients with cystic fibrosis (CF), early intervention and prevention of lung disease is of paramount importance. Principles to achieve this aim include early diagnosis of CF, regular monitoring of the clinical status, various hygienic measures to prevent infection and cross-infection, early use of antibiotic courses in patients with recurrent or continuous bacterial colonisation and appropriate use of chest physiotherapy.
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Affiliation(s)
- Gerd Döring
- Institute of General and Environmental Hygiene, Eberhard, Karls-University of Tübingen, Wilhelmstrasse 31, D-72074 Tübingen, Germany.
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Armstrong D, Bell S, Robinson M, Bye P, Rose B, Harbour C, Lee C, Service H, Nissen M, Syrmis M, Wainwright C. Evidence for spread of a clonal strain of Pseudomonas aeruginosa among cystic fibrosis clinics. J Clin Microbiol 2003; 41:2266-7. [PMID: 12734299 PMCID: PMC154738 DOI: 10.1128/jcm.41.5.2266-2267.2003] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pseudomonas Aeruginosa Infections in Individuals with Cystic Fibrosis. SEVERE INFECTIONS CAUSED BY PSEUDOMONAS AERUGINOSA 2003. [DOI: 10.1007/978-1-4615-0433-7_5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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