Tags

Type your tag names separated by a space and hit enter

Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008.
Pediatr Pulmonol. 2010 Apr; 45(4):363-70.PP

Abstract

STUDY OBJECTIVES

The study objective was to identify changes in cystic fibrosis (CF) sputum microbiology over 13 years.

METHODS

This study recruited a contemporary cohort of CF patients meeting similar eligibility criteria as the 520 subjects in the Phase 3 trials of inhaled tobramycin (historical cohort). Subjects submitted a single sputum specimen to a centralized laboratory for culture and susceptibility testing. Data were summarized and cross-sectional prevalence estimates were compared between cohorts. Exploratory analyses examined associations between recent antibiotic exposures and resistance prevalence.

RESULTS

Sputum samples from 267 subjects from 33 US CF centers were submitted for testing. A total of 656 Pseudomonas aeruginosa isolates were identified from 253 culture-positive subjects. Comparison between cohorts revealed an increase in the prevalence of subjects with tobramycin resistant (11.8% vs. 30.4%, P < 0.001) and amikacin resistant (24.2% vs. 42.7%, P < 0.001) P. aeruginosa. Prevalence of ciprofloxacin resistance was similar (34.4% vs. 33.6%, P = 0.81). Within the contemporary cohort, potential associations between recent antibiotic exposures and prevalence of P. aeruginosa resistance were examined; findings included that exposure to intravenous carbapenems was significantly associated with aztreonam resistance, meropenem resistance, and multidrug resistance (P = 0.0002, P = 0.0003, and P = 0.0002, respectively). Prevalences of Staphylococcus aureus, methicillin-resistant S. aureus, Stenotrophomonas maltophilia, and Achromobacter xylosoxidans were also increased in the contemporary cohort.

CONCLUSIONS

We identified important changes in the patterns of CF airway microbiology, including increased aminoglycoside resistance and prevalence of other antibiotic resistant organisms. These changes are concerning to clinicians caring for individuals with CF because they impact treatment options. These data point to a critical need to develop new antimicrobials for CF.

Authors+Show Affiliations

Seattle Children's Hospital, Seattle, Washington 98101, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Historical Article
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20232473

Citation

Emerson, Julia, et al. "Changes in Cystic Fibrosis Sputum Microbiology in the United States Between 1995 and 2008." Pediatric Pulmonology, vol. 45, no. 4, 2010, pp. 363-70.
Emerson J, McNamara S, Buccat AM, et al. Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008. Pediatr Pulmonol. 2010;45(4):363-70.
Emerson, J., McNamara, S., Buccat, A. M., Worrell, K., & Burns, J. L. (2010). Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008. Pediatric Pulmonology, 45(4), 363-70. https://doi.org/10.1002/ppul.21198
Emerson J, et al. Changes in Cystic Fibrosis Sputum Microbiology in the United States Between 1995 and 2008. Pediatr Pulmonol. 2010;45(4):363-70. PubMed PMID: 20232473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008. AU - Emerson,Julia, AU - McNamara,Sharon, AU - Buccat,Anne Marie, AU - Worrell,Kelly, AU - Burns,Jane L, PY - 2010/3/17/entrez PY - 2010/3/17/pubmed PY - 2010/9/23/medline SP - 363 EP - 70 JF - Pediatric pulmonology JO - Pediatr Pulmonol VL - 45 IS - 4 N2 - STUDY OBJECTIVES: The study objective was to identify changes in cystic fibrosis (CF) sputum microbiology over 13 years. METHODS: This study recruited a contemporary cohort of CF patients meeting similar eligibility criteria as the 520 subjects in the Phase 3 trials of inhaled tobramycin (historical cohort). Subjects submitted a single sputum specimen to a centralized laboratory for culture and susceptibility testing. Data were summarized and cross-sectional prevalence estimates were compared between cohorts. Exploratory analyses examined associations between recent antibiotic exposures and resistance prevalence. RESULTS: Sputum samples from 267 subjects from 33 US CF centers were submitted for testing. A total of 656 Pseudomonas aeruginosa isolates were identified from 253 culture-positive subjects. Comparison between cohorts revealed an increase in the prevalence of subjects with tobramycin resistant (11.8% vs. 30.4%, P < 0.001) and amikacin resistant (24.2% vs. 42.7%, P < 0.001) P. aeruginosa. Prevalence of ciprofloxacin resistance was similar (34.4% vs. 33.6%, P = 0.81). Within the contemporary cohort, potential associations between recent antibiotic exposures and prevalence of P. aeruginosa resistance were examined; findings included that exposure to intravenous carbapenems was significantly associated with aztreonam resistance, meropenem resistance, and multidrug resistance (P = 0.0002, P = 0.0003, and P = 0.0002, respectively). Prevalences of Staphylococcus aureus, methicillin-resistant S. aureus, Stenotrophomonas maltophilia, and Achromobacter xylosoxidans were also increased in the contemporary cohort. CONCLUSIONS: We identified important changes in the patterns of CF airway microbiology, including increased aminoglycoside resistance and prevalence of other antibiotic resistant organisms. These changes are concerning to clinicians caring for individuals with CF because they impact treatment options. These data point to a critical need to develop new antimicrobials for CF. SN - 1099-0496 UR - https://www.unboundmedicine.com/medline/citation/20232473/Changes_in_cystic_fibrosis_sputum_microbiology_in_the_United_States_between_1995_and_2008_ L2 - https://doi.org/10.1002/ppul.21198 DB - PRIME DP - Unbound Medicine ER -