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Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008
Pediatric pulmonology, 2010-04, Vol.45 (4), p.363-370
Emerson, Julia
McNamara, Sharon
Buccat, Anne Marie
Worrell, Kelly
Burns, Jane L.
2010
Details
Autor(en) / Beteiligte
Emerson, Julia
McNamara, Sharon
Buccat, Anne Marie
Worrell, Kelly
Burns, Jane L.
Titel
Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008
Ist Teil von
Pediatric pulmonology, 2010-04, Vol.45 (4), p.363-370
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2010
Link zum Volltext
Quelle
Wiley Online Library - AutoHoldings Journals
Beschreibungen/Notizen
Study Objectives The study objective was to identify changes in cystic fibrosis (CF) sputum microbiology over 13 years. Methods This study recruited a contemporary cohort of CF patients meeting similar eligibility criteria as the 520 subjects in the Phase 3 trials of inhaled tobramycin (historical cohort). Subjects submitted a single sputum specimen to a centralized laboratory for culture and susceptibility testing. Data were summarized and cross‐sectional prevalence estimates were compared between cohorts. Exploratory analyses examined associations between recent antibiotic exposures and resistance prevalence. Results Sputum samples from 267 subjects from 33 US CF centers were submitted for testing. A total of 656 Pseudomonas aeruginosa isolates were identified from 253 culture‐positive subjects. Comparison between cohorts revealed an increase in the prevalence of subjects with tobramycin resistant (11.8% vs. 30.4%, P < 0.001) and amikacin resistant (24.2% vs. 42.7%, P < 0.001) P. aeruginosa. Prevalence of ciprofloxacin resistance was similar (34.4% vs. 33.6%, P = 0.81). Within the contemporary cohort, potential associations between recent antibiotic exposures and prevalence of P. aeruginosa resistance were examined; findings included that exposure to intravenous carbapenems was significantly associated with aztreonam resistance, meropenem resistance, and multidrug resistance (P = 0.0002, P = 0.0003, and P = 0.0002, respectively). Prevalences of Staphylococcus aureus, methicillin‐resistant S. aureus, Stenotrophomonas maltophilia, and Achromobacter xylosoxidans were also increased in the contemporary cohort. Conclusions We identified important changes in the patterns of CF airway microbiology, including increased aminoglycoside resistance and prevalence of other antibiotic resistant organisms. These changes are concerning to clinicians caring for individuals with CF because they impact treatment options. These data point to a critical need to develop new antimicrobials for CF. Pediatr Pulmonol. 2010; 45:363–370. © 2010 Wiley‐Liss, Inc.
Sprache
Englisch
Identifikatoren
ISSN: 8755-6863
eISSN: 1099-0496
DOI: 10.1002/ppul.21198
Titel-ID: cdi_proquest_miscellaneous_733588288
Format
–
Schlagworte
Achromobacter xylosoxidans
,
Adult
,
Anti-Bacterial Agents - therapeutic use
,
Antibacterial agents
,
antibiotic resistance
,
Antibiotics. Antiinfectious agents. Antiparasitic agents
,
Biological and medical sciences
,
Cohort Studies
,
cystic fibrosis
,
Cystic Fibrosis - drug therapy
,
Cystic Fibrosis - epidemiology
,
Cystic Fibrosis - microbiology
,
Drug Resistance, Microbial
,
Errors of metabolism
,
General aspects
,
History, 20th Century
,
History, 21st Century
,
Humans
,
Medical sciences
,
Metabolic diseases
,
methicillin resistant Staphylococcus aureus
,
Miscellaneous hereditary metabolic disorders
,
Pharmacology. Drug treatments
,
Pneumology
,
Prevalence
,
Pseudomonas aeruginosa
,
Pseudomonas Infections - drug therapy
,
Pseudomonas Infections - epidemiology
,
Pseudomonas Infections - microbiology
,
Respiratory Tract Infections - drug therapy
,
Respiratory Tract Infections - epidemiology
,
Respiratory Tract Infections - microbiology
,
Sputum - microbiology
,
Stenotrophomonas maltophilia
,
tobramycin
,
United States - epidemiology
,
Young Adult
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