Is there anything against Abscessus when Tygacil, Amikacin etc have failed?
Hi all, With some desperation, I am looking for some support and ideas on this forum. I have been hospitalized now 3 times for abscessus infection the last 8 years. The first 2 times I bounced back each time a bit after 11 and 6 months hospitalization, thanks to Tygacil which was just on the market. ANd then I stayed out of hospital for 3 years each time. After the birth of my daughter (a miracle!! Thx Gd!), I started crashing and was hospitalized 5 months ago. Unfortunately my abscessus is nowadays resistant against all commonly used drugs such clarithromycin,cefoxitin, moxifloxacin clofamicin,amikacin,meropenem and now also to tygacil. After 5 months in hospital I was discharged this week, as basically there are no options left and the meropenem, amikacin,clarithromycin, tygacil cocktail showed now progress. So I am in worse shape now as I was when i entered hospital and I am really scared big time. I have a 7 months old daughter and sometimes I fear I will not see here become 1 or 2 years. ALso because transplant is not allowed for abcessus patients. So I am just wondering if anyone has heard about or has has any experience with any investigational drugs (e.g.bedaquiline) or is on a special regime or has some nice ideas about alternative or supplemental medication. Anything will be much appreciated!! Thanks a lot and sorry for the melodramatic tone in my message..I am almost 40 and for first time really scared as s...t Warm regards Jeanpaul FEV1: 1,0 ltr, Df508 and E528X...
Compositional changes in the microbiome are associated with the development of bronchiolitis obliterans (BO) after lung transplantation (LTx) in adults with cystic fibrosis (CF). The association between the lower airway bacterial community and BO after LTx in children with CF remains largely unexplored and is possibly influenced by frequent antibiotic therapy.
We report the case of a SARS-CoV-2 infection in a lung-transplanted patient for cystic fibrosis characterized by several singularities.
Journal of Palliative Medicine, Ahead of Print.
CONCLUSIONS: Patients who underwent Unplanned-Intraoperative ECMO showed poorer prognoses than patients who did not require ECMO. This finding may be explained by differences in initial condition severity, by long-term consequences of the intraoperative complications leading to ECMO pump implantation, or by flaws in our weaning protocol. PMID: 32380057 [PubMed - as supplied by publisher]
AbstractThe pig is an omnivorous, monogastric species with many advantages to serve as an animal model for human diseases. There are very high similarities to humans in anatomy and functions of the immune system, e g., the presence of tonsils, which are absent in rodents. The porcine immune system resembles man for more than 80% of analyzed parameters in contrast to the mouse with only about 10%. The pig can easily be bred, and there are less emotional problems to use them as experimental animals than dogs or monkeys. Indwelling cannulas in a vein or lymphatic vessel enable repetitive stress-free sampling. Meanwhile, there...
CONCLUSIONS: No randomised or quasi-randomised clinical trials of gene therapy for haemophilia were identified. Thus, we are unable to determine the safety and efficacy of gene therapy for haemophilia. Gene therapy for haemophilia is still in clinical investigation and there is a need for well-designed clinical trials to assess the long-term feasibility, success and risks of gene therapy for people with haemophilia. PMID: 32342499 [PubMed - in process]
Persistent air leak (PAL) is a common problem after secondary pneumothorax due to cystic fibrosis (CF). These leaks, caused by either bronchopleural or alveolopleural fistula, are associated with higher morbidity and mortality . Air leaks are traditionally treated with chronic chest tube drainage, chemical pleurodesis, or autologous blood patching in non-surgical candidates . However, these strategies can increase infectious risk or pleural scarring, which are associated with poorer lung transplant surgical outcomes.
This article reviews the specific imaging features of CF using conventional imaging modalities (chest radiographs and high-resolution computed tomography [HRCT]) as well as emerging imaging technologies (digital chest tomosynthesis and MR imaging). In addition, the authors review the CF-specific HRCT imaging findings that are essential in the evaluation of these patients in the pre-lung transplant and post-lung transplant settings. PMID: 32276698 [PubMed - as supplied by publisher]
Bilateral lung transplantation (LTx) is a complex but important therapeutic option for end-stage cystic fibrosis (CF) patients, with a significant risk of perioperative morbidity and mortality [1,2]. Patients should be referred for LTx when pulmonary function has declined to 30% of predicted Forced Expiratory Volume in 1 s (FEV1% predicted) or when worsening rapidly . After LTx, pulmonary function, quality of life, and life expectancy can improve drastically [2,3].
Cystic fibrosis (CF) is today the second most common primary indication for bilateral lung transplantation in adults and the third most common indication for lung transplantation in adults overall according to the most recent Thoracic Transplant Registry Report of the International Society for Heart and Lung Transplantation (ISHLT) (1). In children and adolescents, CF is the commonest reason for transplantation reaching 2/3rd in children older than 11 years (2). In general, lung transplantation is considered a life-saving therapy option in well selected patients with respiratory failure due to advanced CF lung disease (3).