Microbiology of Upper Respiratory Tract Pathogens in Cystic Fibrosis Patients
Cystic fibrosis (CF) is an inherited genetic disorder with chronic respiratory manifestations. The respiratory symptoms may start very early in life. The aim of this study was to evaluate the prevalence and antimicrobial susceptibility of respiratory pathogens in children with CF. In this clinical laboratory study, 100 CF patients were prospectively collected from February 2016 to March 2017. Microbiological cultures and antimicrobial susceptibility tests of the most frequently isolated upper respiratory tract bacteria were performed. According to the results of this study, Staphylococcus aureus was the most frequent microorganism 24 (24%) in CF patients followed by Pseudomonas aeruginosa 21 (21%). In children younger than one-year-old, Enterococci and Klebsiella pneumonia were the most frequently isolated pathogens. In other age groups, Staphylococcus aureus and Pseudomonas aeroginosa were most frequent. All pathogens showed more sensitivity to Ceftriaxone, Amikacin, and Ceftazidime. However, Staphylococcus aureus was most sensitive to Cefoxitin, Clindamycin, and Linezolid and Pseudomonas aeroginosa were most sensitive to Amikacin, Ceftazidime, and Ceftriaxone respectively. In conclusion, Staphylococcus aureus and Pseudomonas aeroginosa were the most frequent microorganisms in CF patients in our population. In patients younger than one-year-old, the most frequent pathogens were Enterococci and Klebsiella. All pathogens and Pseudomonas aeroginosa were sensitive to Ceftriaxone, Amikacin, and Ceftazidime but Staphylococcus aureus was most sensitive to Cefoxitin, Clindamycin, and Linezolid respectively. It seems that Ceftriaxone, Amikacin, and Ceftazidime are the most suitable antibiotics for the treatment of pulmonary infections in CF patients in our population.
Welsh M, Ramsey B, Accurso F, Cutting G, Scriver C, Beaudet A, et al. The metabolic and molecular basis of inherited disease. Scriver, CR. 2001:5121-89.
Ramsey BW. Management of pulmonary disease in patients with cystic fibrosis. New England Journal of Medicine. 1996;335(3):179-88.
MacKenzie T, Gifford AH, Sabadosa KA, Quinton HB, Knapp EA, Goss CH, et al. Longevity of Patients With Cystic Fibrosis in 2000 to 2010 and Beyond: Survival Analysis of the Cystic Fibrosis Foundation Patient RegistryLifetime of Patients With Cystic Fibrosis in 2000 to 2010 and Beyond. Annals of internal medicine. 2014;161(4):233-41.
O'Sullivan B, Freedman S. Carrier screening for cystic fibrosis–Authors' reply. The Lancet. 2009;374(9694):978.
LiPuma JJ. The changing microbial epidemiology in cystic fibrosis. Clinical microbiology reviews. 2010;23(2):299-323.
Lyczak JB, Cannon CL, Pier GB. Lung infections associated with cystic fibrosis. Clinical microbiology reviews. 2002;15(2):194-222.
Kahl BC, Duebbers A, Lubritz G, Haeberle J, Koch HG, Ritzerfeld B, et al. Population dynamics of persistent Staphylococcus aureus isolated from the airways of cystic fibrosis patients during a 6-year prospective study. Journal of clinical microbiology. 2003;41(9):4424-7.
Marshall B, Elbert A, Petren K, Rizvi S, Fink A, Ostrenga J, et al. Cystic fibrosis foundation patient registry 2014 annual data report. Cyst Fibros Found. 2014:1-92.
Henry RL, Mellis CM, Petrovic L. Mucoid Pseudomonas aeruginosa is a marker of poor survival in cystic fibrosis. Pediatric pulmonology. 1992;12(3):158-61.
Frederiksen B, Lanng S, Koch C, Hølby N. Improved survival in the Danish center‐treated cystic fibrosis patients: Results of aggressive treatment. Pediatric pulmonology. 1996;21(3):153-8.
Renders NH, Belkum Av, Overbeek SE, Mouton JW, Verbrugh HA. Molecular epidemiology of Staphylococcus aureus strains colonizing the lungs of related and unrelated cystic fibrosis patients. Clinical Microbiology and Infection. 1997;3(2):216-21.
Renders N, Sijmons M, van Belkum A, Overbeek S, Mouton J, Verbrugh H. Exchange of Pseudomonas aeruginosa strains among cystic fibrosis siblings. Research in microbiology. 1997;148(5):447-54.
Emerson J, Rosenfeld M, McNamara S, Ramsey B, Gibson RL. Pseudomonas aeruginosa and other predictors of mortality and morbidity in young children with cystic fibrosis. Pediatric pulmonology. 2002;34(2):91-100.
Goss CH, Rosenfeld M. Update on cystic fibrosis epidemiology. Current opinion in pulmonary medicine. 2004;10(6):510-4.
LiPuma JJ. Expanding microbiology of pulmonary infection in cystic fibrosis. The Pediatric infectious disease journal. 2000;19(5):473-4.
LiPuma JJ, editor Burkholderia and emerging pathogens in cystic fibrosis. Seminars in respiratory and critical care medicine; 2003: Copyright© 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.:+ 1 (212) 584-4662.
Millar F, Simmonds N, Hodson M. Trends in pathogens colonising the respiratory tract of adult patients with cystic fibrosis, 1985–2005. Journal of Cystic Fibrosis. 2009;8(6):386-91.
Emerson J, McNamara S, Buccat AM, Worrell K, Burns JL. Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008. Pediatric pulmonology. 2010;45(4):363-70.
Conway SP, Brownlee KG, Denton M, Peckham DG. Antibiotic treatment of multidrug-resistant organisms in cystic fibrosis. American Journal of Respiratory Medicine. 2003;2(4):321-32.
Banerjee D, Stableforth D. The treatment of respiratory Pseudomonas infection in cystic fibrosis. Drugs. 2000;60(5):1053-64.
Dakin CJ, Numa AH, Wang H, Morton JR, Vertzyas CC, Henry RL. Inflammation, infection, and pulmonary function in infants and young children with cystic fibrosis. American Journal of Respiratory and Critical Care Medicine. 2002;165(7):904-10.
Hoppe JE, Theurer-Mainka U, Stern M. Comparison of three methods for culturing throat swabs from cystic fibrosis patients. Journal of clinical microbiology. 1995;33(7):1896-8.
Razvi S, Quittell L, Sewall A, Quinton H, Marshall B, Saiman L. Respiratory microbiology of patients with cystic fibrosis in the United States, 1995 to 2005. Chest. 2009;136(6):1554-60.
Lambiase A, Raia V, Del Pezzo M, Sepe A, Carnovale V, Rossano F. Microbiology of airway disease in a cohort of patients with cystic fibrosis. BMC infectious diseases. 2006;6(1):4.
Berkhout M, Rijntjes E, El Bouazzaoui L, Fokkens W, Brimicombe R, Heijerman H. Importance of bacteriology in upper airways of patients with cystic fibrosis. Journal of Cystic Fibrosis. 2013;12(5):525-9.
Valenza G, Tappe D, Turnwald D, Frosch M, König C, Hebestreit H, et al. Prevalence and antimicrobial susceptibility of microorganisms isolated from sputa of patients with cystic fibrosis. Journal of Cystic Fibrosis. 2008;7(2):123-7.
Paixão VA, Barros TF, Mota CMC, Moreira TF, Santana MA, Reis JN. Prevalence and antimicrobial susceptibility of respiratory pathogens in patients with cystic fibrosis. The Brazilian Journal of Infectious Diseases. 2010;14(4):406-9.
Coburn B, Wang PW, Caballero JD, Clark ST, Brahma V, Donaldson S, et al. Lung microbiota across age and disease stage in cystic fibrosis. Scientific reports. 2015;5.
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