期刊
BMC PULMONARY MEDICINE
卷 17, 期 -, 页码 -出版社
BIOMED CENTRAL LTD
DOI: 10.1186/s12890-017-0482-7
关键词
Cross-infection; Cystic fibrosis; Disease progression; Pseudomonas Aeruginosa; Respiratory tract infections
资金
- National Health and Medical Research Council (NHMRC) [455919]
- Children's Health Foundation Queensland [50007]
- Queensland Health Office of Health and Medical Research
- Australian Cystic Fibrosis Research Trust [2009-06]
- Prince Charles Hospital Foundation
- Rotary Australia
- CF Foundation Therapeutics (USA)
- NHMRC [APP1017517, 1088448, APP1054129]
- Australian Cystic Fibrosis Research Trust
- ERS-EU RESPIRE2 Marie Sklodowska-Curie [4571-2013]
- Australian Postgraduate Award PhD Scholarship [2127932]
- Queensland Health, Health Research Fellowship [QCOS013795]
- Shelley Shephard Memorial Scholarship
- National Health and Medical Research Council of Australia [1088448] Funding Source: NHMRC
Background: Pulmonary exacerbations in cystic fibrosis (CF) remain poorly understood and treatment is usually targeted at Pseudomonas aeruginosa. Within Australia a predominant shared P. aeruginosa strain (AUST-02) is associated with greater treatment needs. This single centre study assessed temporal shared strain population dynamics during and after antibiotic treatment of exacerbations. Methods: Sputum was collected from 12 adult patients with a history of chronic AUST-02 infection at four time-points during and after treatment of an exacerbation. Forty-eight P. aeruginosa isolates within each sample underwent AUST-02 allele-specific PCR and SNP-based strain genotyping. Results: Various commonly shared Australian strains (AUST-01, 0.1%; AUST-02, 54.3%; AUST-06, 36.6%; AUST-07, 4.6%; AUST-11, 4.3%) and two unique strains (0.1%) were identified from 45 sputum samples (2160 isolates). Based on within-patient relative abundance of strains, a single-strain infection (n = 7) or mixed-strain infection (n = 5) was assigned to each patient. A significant temporal variation in the P. aeruginosa population composition was found for those with mixed-strain infection (P < 0.001). Patients with mixed-strain infections had more long-term treatment requirements than those with single-strain infection. Moreover, despite both groups having similar lung function at study entry, patients with single-strain infection had greater improvement in FEV1% predicted following their exacerbation treatment (P = 0.02). Conclusion: Pulmonary exacerbations may reveal multiple, unrelated P. aeruginosa strains whose relative abundance with one another may change rapidly, in a sustained and unpredictable manner.
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