Journal Information
Vol. 16. Issue 2.
Pages 122-128 (March - April 2012)
Share
Share
Download PDF
More article options
Vol. 16. Issue 2.
Pages 122-128 (March - April 2012)
Open Access
A survey on pulmonary pathogens and their antibiotic susceptibility among cystic fibrosis patients
Visits
2655
Ghamartaj Khanbabaeea,
Corresponding author
khanbabaeegh@yahoo.com

Corresponding author at: Department of Pediatric Respiratory Diseases, Mofid Children Hospital, Shariati St, Tehran, 15468-15514, Iran.
, Majidreza Akbarizadehb, Aliakbar Sayyaric, Mitra Ashayeri-Panahd, Fatemeh Abdollahgorjie, Kourosh Sheibanif, Nima Rezaeig
a Department of Pediatric Respiratory Diseases, CF Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
b Department of Pediatrics, Zabol University of Medical Sciences, Zabol, Iran
c Department of Pediatric Gastroenterology Diseases, CF Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
d Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, Tehran, Iran
e Clinical Research and Development Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
f Clinical Research and Development Center, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
g Research Center for Immunodeficiencies; and Molecular Immunology Research Center, Children's Medical Center, Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
This item has received

Under a Creative Commons license
Article information
Abstract
Bibliography
Download PDF
Statistics
Abstract
Objective

This study was performed to investigate frequency and antimicrobial susceptibility of pulmonary pathogens in cystic fibrosis (CF) patients.

Methods

129 pediatric patients with CF were enrolled in this cross-sectional study. Microbiological cultures were performed based on sputum or pharyngeal swabs. Antibiotic susceptibilities of the isolated bacteria were determined by the disk diffusion method.

Results

The main infecting pathogens were Pseudomonas aeruginosa (38.8%), Klebsiella pneumoniae (11.6%) and Staphyloccus areus (9.3%), respectively. The most active antibiotics included rifampin (91.7% susceptibility), vancomycin (85%) and imipenem (83.5%). Emerging resistance against aminoglycosides was observed.

Conclusion

Regarding in vitro susceptibility results, cyclic treatment of long-term oral azithromycin and inhaled tobramycin could prophylactically be applied, and during exacerbations, imipenem or ceftazidime in combination with an aminoglycoside such as amikacin could be considered the drugs of choice.

Keywords:
Cystic fibrosis
Respiratory tract infections
Products with antimicrobial action
Full text is only aviable in PDF
References
[1.]
T.F. Boat.
Cystic Fibrosis.
Nelson Textbook of Pediatrics, 17th edition, pp. 1437-1449
[2.]
Cystic Fibrosis Foundation.
Cystic Fibrosis Foundation Patient Registry, 2006 Annual data report to the center directors.
Cystic Fibrosis Foundation, (2007),
[3.]
J.C. Davies, D. Bilton.
Bugs, biofilms, and resistance in cystic fibrosis.
Respir Care, 54 (2009), pp. 628-640
[4.]
F.A. Ratjen.
Cystic fibrosis: pathogenesis and future treatment strategies.
Respir Care, 54 (2009), pp. 595-605
[5.]
H. Matsui, B.R. Grubb, R. Tarran, et al.
Evidence for periciliary liquid layer depletion, not abnormal ion composition, in the pathogenesis of cystic fibrosis airways disease.
Cell, 95 (1998), pp. 1005-1015
[6.]
A. Stone, L. Saiman.
Update on the epidemiology and management of Staphylococcus aureus, including methicillinresistant Staphylococcus aureus, in patients with cystic fibrosis.
Curr Opin Pulm Med, 13 (2007), pp. 515-521
[7.]
C.A. Merlo, M.P. Boyle, M. Diener-West, et al.
Incidence and Risk Factors for Multiple Antibiotic-Resistant Pseudomonas aeruginosa in Cystic Fibrosis.
Chest, 132 (2007), pp. 562-568
[8.]
P.M. Farrell, B.J. Rosenstein, T.B. White, et al.
Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report.
J Pediatr, 153 (2008), pp. S4-S14
[9.]
J.F. Mac Faddin.
Biochemical tests for identification of medical bacteria.
3rd edition, Williams & Wilkins, (1999),
[10.]
Clinical, Laboratory Standards Institute.
Performance standards for antimicrobial disk susceptibility tests, Approved standard M2-A10.
10th edition, Clinical and Laboratory Standards Institute, (2009),
[11.]
J.L. Burns, J. Emerson, J.R. Stapp, et al.
Microbiology of sputum from patients at cystic fibrosis centers in the United States.
Clin Infect Dis, 27 (1998), pp. 158-163
[12.]
G. Valenza, D. Tappe, D. Turnwald, et al.
Prevalence and antimicrobial susceptibility of microorganisms isolated from sputa of patients with cystic fibrosis.
J Cyst Fibros, 7 (2008), pp. 123-127
[13.]
J. Emerson, S. McNamara, A.M. Buccat, et al.
Changes in cystic fibrosis sputum microbiology in the United States between 1995 and 2008.
Pediatr Pulmonol, 45 (2010), pp. 363-370
[14.]
S. Razvi, L. Quittell, A. Sewall, et al.
Respiratory microbiology of patients with cystic fibrosis in the United States, 1995 to 2005.
Chest, 136 (2009), pp. 1554-1560
[15.]
H.V. Olesen, T. Pressler, L. Hjelte, et al.
Gender differences in the Scandinavian cystic fibrosis population.
Pediatr Pulmonol, 45 (2010), pp. 959-965
[16.]
H. Levy, L.A. Kalish, C.L. Cannon, et al.
Predictors of mucoid Pseudomonas colonization in cystic fibrosis patients.
Pediatr Pulmonol, 43 (2008), pp. 463-471
[17.]
N.S. Champs, D.L. Gomes, C.G. Alvin, et al.
Early colonization by Staphylococcus aureus and Pseudomonas aeruginosa in newborn screening children.
J Cyst Fibros, 8 (2009), pp. S64
[18.]
R.S. Leão, R.H.V. Pereira, T.W. Folescu, et al.
KPC-2 Carbapenemase-producing Klebsiella pneumoniae isolates from patients with cystic fibrosis.
J Cyst Fibros, 10 (2011), pp. 140-142
[19.]
F. Bittar, H. Richet, J.C. Dubus, et al.
Molecular detection of multiple emerging pathogens in sputa from cystic fibrosis patients.
[20.]
A. Tazumi, Y. Maeda, C.E. Goldsmith, et al.
Molecular characterization of macrolide resistance determinants [erm (B) and mef (A)] in Streptococcus pneumoniae and viridans group streptococci (VGS) isolated from adult patients with cystic fibrosis (CF).
J Antimicrob Chemother, 64 (2009), pp. 501-506
[21.]
Y. Maeda, J.S. Elborn, M.D. Parkins, et al.
Population structure and characterization of viridans group streptococci (VGS) including Streptococcus pneumoniae isolated from adult patients with cystic fibrosis (CF).
J Cyst Fibros, 10 (2011), pp. 133-139
[22.]
J. Foweraker.
Recent advances in the microbiology of respiratory tract infection in cystic fibrosis.
Br Med Bull, 89 (2009), pp. 93-110
[23.]
L.A. Garske, T.J. Kidd, R. Gan, et al.
Rifampicin and sodium fusidate reduce the frequency of methicillin-resistant Staphylococcus aureus (MRSA) isolation in adults with cystic fibrosis and chronic MRSA infection.
J Hosp Infect, 56 (2004), pp. 208-214
[24.]
V. Cafiso, D. Bertuccio, F. Campanile, et al.
Methicillin resistance and vancomycin heteroresistance in Staphylococcus aureus in cystic fibrosis patients.
Eur J Clin Microbiol Infect Dis, 29 (2010), pp. 1277-1285
[25.]
M.R. Jacobs.
Antimicrobial-resistant Streptococcus pneumoniae: trends and management.
Expert Rev Anti Infect Ther, 6 (2008), pp. 619-635
[26.]
D.J. Wolter, D. Acquazzino, R.V. Goering, et al.
Emergence of carbapenem resistance in Pseudomonas aeruginosa isolates from a patient with cystic fibrosisin the absence of carbapenem therapy.
Clin Infect Dis, 46 (2008), pp. e137-e141
[27.]
B. Stuart, J.H. Lin, P.J. Mogayzel Jr..
Early Eradication of Pseudomonas aeruginosa in Patients with Cystic Fibrosis.
Paediatr Respir Rev, 11 (2010), pp. 177-184
[28.]
F. Ratjen, F. Brockhaus, G. Angyalosi.
Aminoglycoside therapy against Pseudomonas aeruginosa in cystic fibrosis: A review.
J Cyst Fibros, 8 (2009), pp. 361-369
[29.]
T. Nguyen, S.G. Louie, P.M. Beringer, et al.
Potential role of macrolide antibiotics in the management of cystic fibrosis lung disease.
Curr Opin Pulm Med, 8 (2002), pp. 521-528
[30.]
K.W. Southern, P.M. Barker, A. Solis.
Macrolide antibiotics for cystic fibrosis.
Cochrane Database of Syst Rev, 2 (2004),
[31.]
L. Saiman, M. Ansteasd, Mayer-Hamblett, et al.
Effect of azithromycin on pulmonary function in patients with cystic fibrosis uninfected with Pseudomonas aeruginosa.
J Am Med Assoc, 303 (2010), pp. 1707-1715
Copyright © 2012. Elsevier Editora Ltda.. All rights reserved
The Brazilian Journal of Infectious Diseases
Article options
Tools