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Increased treatment requirements of patients with cystic fibrosis who harbour a highly transmissible strain of Pseudomonas aeruginosa
  1. A M Jones1,
  2. M E Dodd1,
  3. C J Doherty2,
  4. J R W Govan2,
  5. A K Webb1
  1. 1Bradbury Cystic Fibrosis Unit, South Manchester NHS Trust, Wythenshawe Hospital, Manchester M23 9LT, UK
  2. 2Department of Medical Microbiology, University of Edinburgh, Edinburgh EH8 9AG, UK
  1. Correspondence to:
    Dr A M Jones, Adult Cystic Fibrosis Centre, South Manchester NHS Trust, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK;
    andmarkj{at}hotmail.com

Abstract

Background: A group of patients who harbour the same highly transmissible strain of Pseudomonas aeruginosa were identified at a cystic fibrosis (CF) centre. Isolates of this strain display a number of unusual phenotypic features including resistance to most typical antipseudomonal antibiotics. A study was undertaken to see if there was a difference in treatment requirements between CF patients with chronic infection with their own unique P aeruginosa strains (group 1) and those who harbour a highly transmissible strain (group 2).

Methods: Data on treatment requirements for the year 2000 were collected from the case records of CF patients with chronic P aeruginosa infection who had received inpatient treatment. Patients co-infected with Burkholderia cepacia or other highly transmissible strains of P aeruginosa were excluded.

Results: There were 2/56 and 3/22 deaths in groups 1 and 2, respectively; these patients were excluded from the analysis. No difference was found between the two groups for mean age, % predicted forced expiratory volume in 1 second (FEV1), % predicted forced vital capacity (FVC), and body mass index. Patients in group 2 had a greater median (range) number of intravenous antibiotic days (60 (17–216) v 33 (4–237) days; p=0.01), inpatient days (39 (7–183) v 16 (1–172) days; p<0.01), and inpatient episodes (3 (1–9) v 2 (1–6); p<0.01), and more respiratory exacerbations (mean (SD) 8.2 (3.4) v 6.1 (3.2); p=0.01).

Conclusions: Patients who harbour the highly transmissible P aeruginosa strain have a greater treatment burden than patients with CF who harbour their own unique strains. These findings support the need for microbiological surveillance for highly transmissible P aeruginosa and the implementation of infection control measures to prevent cross infection.

  • cystic fibrosis
  • cross infection
  • Pseudomonas aeruginosa
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Footnotes

  • Conflict of interest: none.

  • Unfunded study.

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