Article Text

other Versions

PDF

Concordant genotype of upper and lower airways P.aeruginosa and S.aureus isolates in cystic fibrosis
  1. Jochen G Mainz (jochen.mainz{at}med.uni-jena.de)
  1. University of Jena, CF-Centre, Germany
    1. Lutz Naehrlich (lutz.naehrlich{at}uk-erlangen.de)
    1. University of Erlangen-Nuernberg, Department of Pediatrics, Germany
      1. Matthias Schien (matthias.schien{at}med.uni-jena.de)
      1. University of Jena, CF-Centre, Germany
        1. Manfred Käding (m.kaeding{at}skc.de)
        1. CF Center, Chemnitz Hospital, Germany
          1. Isabella Schiller (isabella.schiller{at}med.uni-jena.de)
          1. University of Jena, CF-Centre, Germany
            1. Susanne Mayr (susanne.mayr{at}uk-erlangen.de)
            1. University of Erlangen-Nuernberg, Otorhinolaryngology, Germany
              1. Gerlind Schneider (gerlind.schneider{at}med.uni-jena.de)
              1. University of Jena, Otorhinology, Germany
                1. Lutz Wiehlmann (wiehlmann.lutz{at}mh-hannover.de)
                1. Klinische Forschergruppe, Pediatric Pneumology, Medizinische Hochschule Hannover, Germany
                  1. Nina Cramer (cramer.nina{at}mh-hannover.de)
                  1. Klinische Forschergruppe, Pediatric Pneumology, Medizinische Hochschule Hannover, Germany
                    1. Wolfgang Pfister (w.pfister{at}med.uni-jena.de)
                    1. University of Jena, Microbiology, Germany
                      1. Barbara C Kahl (kahl{at}uni-muenster.de)
                      1. Institute of Medical Microbiology, University Hospital Münster, Germany
                        1. James F Beck (james.beck{at}med.uni-jena.de)
                        1. University of Jena, Pediatrics, Germany
                          1. Burkhard Tummler (tuemmler.burkhard{at}mh-hannover.de)
                          1. Klinische Forschergruppe, Pediatric Pneumology, Medizinische Hochschule Hannover, Germany

                            Abstract

                            Rationale: Lower airway (LAW) infection with Pseudomonas aeruginosa (P.a.) and Staphylococcus aureus (S.a.) is the leading cause of morbidity in Cystic Fibrosis (CF). The upper airways (UAW) were shown to be a gateway for acquisition and reservoir of opportunistic bacteria. Therefore, tools for UAW-assessment within CF-routine care require evaluation.

                            Objectives: Aims of the study were non-invasive assessment of UAW and LAW microbial colonization and genotyping of P.a. and S.a. strains from both segments.

                            Methods: 182 CF-patients were evaluated (age 0.4-68yrs, median 17yrs). LAW specimens were preferably sampled as expectorated sputum and UAW specimens by nasal lavage. P.a. and S.a.-isolates were typed in informative single nucleotide polymorphisms (SNPs) or by spa typing, respectively.

                            Results: Of the typable S.a. and P.a. isolates from concomitant UAW- and LAW-positive specimens, 31 of 36 patients were carrying identical S.a. spa types and 23 of 24 patients identical P.a. SNP-genotypes in both compartments. Detection of S.a. or P.a. in LAW specimens was associated with a 15- or 88-fold higher likelihood to also identify S.a. or P.a. in a UAW specimen from the same patient.

                            Conclusions: The presence of the same genotypes in UAW and LAW suggests a role of UAW as a reservoir of S.a. and P.a. in CF. Nasal lavage appears to be suitable for non-invasive UAW-sampling but further longitudinal analyses and comparison with invasive methods are required. While UAW bacterial colonization is typically not assessed in regular CF-care, our data challenge the need to discuss diagnostic and therapeutic standards for this airway compartment.

                            Statistics from Altmetric.com

                            Request permissions

                            If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.