Chest
Clinical InvestigationsCystic FibrosisFactors Affecting the Incidence of Stenotrophomonas maltophilia Isolation in Cystic Fibrosis
Section snippets
Study Design
Two identical, randomized, placebo-controlled trials of TSI were conducted.13 Patients were randomized to treatment either with 300 mg bid TSI (TOBI; Chiron; Emeryville, CA) or a taste-masked placebo administered bid. The study drug was administered in a series of cycles consisting of 28 days receiving the drug followed by 28 days not receiving the drug.13 The study design, study drug formulation, and drug delivery have been described previously.13 During the trials, patients could receive any
Demographic Data
A total of 520 patients were enrolled in the trials (TSI group, 258 patients; placebo group, 262 patients). Of these, 464 (89.2%) completed 6 months of treatment (TSI group, 232 patients [89.9%]; placebo group, 232 patients [88.6%]). There were no significant differences in the baseline characteristics of the two treatment groups (Table 1). When evaluated by S maltophilia culture status (ie, yes/no), demographic data revealed proportionally more pediatric patients and fewer adult patients among
Discussion
S maltophilia is an opportunistic pathogen that commonly infects the respiratory tract of patients with CF. The role that S maltophilia plays in the pathophysiology of CF lung disease is uncertain, but in light of the resistance to the antibiotic agents commonly used to manage CF patients, the reported increase in the isolation of S maltophilia from CF sputum3,5,6,7 has become a cause for concern within the CF community. The current study was undertaken to determine whether inhaled tobramycin
ACKNOWLEDGMENT
We gratefully acknowledge the contribution of the staff of Chiron Corporation, including Diane Gordon, Dutch VanDevanter, Blake Hoskins, Jill Van Dalfsen, Xin Yu, and Uta Meyer, in the preparation of this manuscript.
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2021, Infection Prevention in PracticeHealthy scents: microbial volatiles as new frontier in antibiotic research?
2018, Current Opinion in MicrobiologyCitation Excerpt :Homologs occur in many bacteria. One example is Stenotrophomonas maltophilia, a Gram-negative bacterium that is found ubiquitously in different environments, including nosocomial infections where it affects biofilm formation in Pseudomonas aeruginosa, a lung pathogen associated with cystic fibrosis [54,55]. An important activity of MVCs in the light of this review is their ability to modulate antibiotic resistance.
Emerging bacterial pathogens and changing concepts of bacterial pathogenesis in cystic fibrosis
2015, Journal of Cystic FibrosisFactors influencing the acquisition of Stenotrophomonas maltophilia infection in cystic fibrosis patients
2013, Journal of Cystic FibrosisCitation Excerpt :Our investigations also demonstrated that patients with steeper rates of FEV1 decline were at increased risk of acquiring S. maltophilia infection. Retrospective case control studies also suggested that increased antibiotic use (intravenous, oral or inhaled) was more common in CF individuals with S. maltophilia [6,11,12]; however, due to their cross-sectional nature, these studies were not able to determine whether antibiotic use preceded S. maltophilia infection. In addition, retrospective analysis of randomized, placebo-controlled trials of inhaled tobramycin showed that oral ciprofloxacin (but not inhaled tobramycin) was a significant risk factor for S. maltophilia acquisition, although this study was conducted solely in adult CF patients with chronic P. aeruginosa endobronchial infections [12].
Vibrio cholerae (Cholera)
2012, Principles and Practice of Pediatric Infectious Diseases, Fourth Edition
Data for this study were obtained from the tobramycin solution for inhalation trials, provided by Chiron. Chiron also provided statistical analysis of the data presented under supervision of the authors. The authors received no financial support for the preparation of this manuscript, although they have received grant support and/or honoraria from Chiron for other projects.