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Bacterial colonisation withXanthomonas maltophilia — A retrospective study in a cystic fibrosis patient population

Bakterielle Kolonisierung mitXanthomonas maltophilia bei Patienten mit zystischer Fibrose — Eine retrospektive Studie

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Summary

Xanthomonas maltophilia was isolated from 25 of 150 patients with cystic fibrosis during a period of 10 years (1983–1992). Twelve patients harbouredX. maltophilia chronically, i.e. repeatedly for more than 6 months. No predisposing factors for the colonisation could be identified by studying the clinical and laboratory data of the patients, including preceding and concurrent bacterial colonisation with other bacteria, antibacterial treatments, pulmonary function and biochemical markers. Up to 2 years after the chronic colonisation was established no clinical deterioration could be verified, but the patients withX. maltophilia generally had a worse lung function at the latest follow-up (2–7 years after colonisation) than controls colonised withPseudomonas aeruginosa (p<0.05). Our data imply thatX. maltophilia is a pathogen and the colonisation appears to follow the same pattern as the colonisation byP. aeruginosa. The development of resistance to different antibiotics, as revealed by analysis of the inhibition zones, was related to antibacterial treatment courses.X. maltophilia showed reduced sensitivity to the most commonly used antibiotics, ceftazidime and tobramycin.

Zusammenfassung

Xanthomonas maltophilia wurde bei 25 von 150 Patienten während eines Zeitraumes von 10 Jahren (1983–1992) isoliert. 12 Patienten hatten eine chronische Kolonisierung, das heißt bestehend während mehr als 6 Monaten. Prädisponierende Faktoren konnten bei der Analyse der klinischen Daten und Labordaten nicht festgestellt werden, frühere und gleichzeitige Kolonisierung mit anderen Bakterien, Lungenfunktion und biochemische Parameter inbegriffen. Bis zu 2 Jahre nachdem die chronische Kolonisierung etabliert worden war, fanden wir keine klinische Verschlechterung. Die langfristige Verlaufskontrolle (2–7 Jahre) zeigte, daß Patienten mitX. maltophilia meistens eine schlechtere Lungenfunktion hatten als Kontrollfälle, die mitPseudomonas aeruginosa kolonisiert worden waren (p<0,05). Unsere Daten deuten an, daß bei Patienten mit zystischer FibroseX. maltophilia ein pathogener Erreger ist und die Kolonisierung nach demselben Muster zu erfolgen scheint wie die Kolonisierung mitP. aeruginosa. Die Entwicklung der Antibiotikaresistenz wurde durch Bestimmung der Hemmzonen im Verhältnis zu Antibiotikabehandlungen verfolgt.X. maltophilia zeigte eine herabgesetzte Empfindlichkeit gegen die meisten Antibiotika. In unserer Serie gab es eine markante Resistenzentwicklung gegen Ceftazidim und Tobramycin während der chronischen Kolonisierung.

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Authors and Affiliations

  1. Dept. of Paediatrics Karolinska Institutet, Huddinge Hospital, S-141 86, Huddinge

    F. Karpati M. D. & L. Hjelte M. D., Ph. D.

  2. Dept. of Microbiology, Karolinska Institutet, Huddinge Hospital, S-141 86, Huddinge

    A. -S. Malmborg M. D., Ph. D. & H. Alfredsson B. Sc.

  3. Dept. of Paediatrics, Faculty of Medicine, Göteborg University, S-416 85, Göteborg, Sweden

    B. Strandvik M. D., Ph. D.

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  1. F. Karpati M. D.
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  2. A. -S. Malmborg M. D., Ph. D.
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  3. H. Alfredsson B. Sc.
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  4. L. Hjelte M. D., Ph. D.
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Karpati, F., Malmborg, A.S., Alfredsson, H. et al. Bacterial colonisation withXanthomonas maltophilia — A retrospective study in a cystic fibrosis patient population. Infection 22, 258–263 (1994). https://doi.org/10.1007/BF01739911

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