Microbiology of Cystic Fibrosis Airway Disease
Semin Respir Crit Care Med 2019; 40: 727-736 DOI: 10.1055/s-0039-1698464Although survival of individuals with cystic fibrosis (CF) has been continuously improving for the past 40 years, respiratory failure secondary to recurrent pulmonary infections remains the leading cause of mortality in this patient population. Certain pathogens such as Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and species of the Burkholderia cepacia complex continue to be associated with poorer clinical outcomes including accelerated lung function decline and increased mortality. In addition, other organisms such as anaerobes, viruses, and fungi are increasingly recognized as potential contributors to disease progression. Culture-independent molecular methods are also being used for diagnostic purposes and to examine the interaction of microorganisms in the CF airway. Given the importance of CF airway infections, ongoing initiatives to promote understanding of the epidemiology, clinical course, and treatment options for these infections are needed. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text
Staphylococcus aureus remains a leading cause of human infection. These infections frequently recur when the skin is a primary site of infection, especially in infants and children. In contrast, invasive staphylococcal disease is less commonly associated with reinfection, suggesting that tissue-specific mechanisms govern the development of immunity. Knowledge of how S. aureus manipulates protective immunity has been hampered by a lack of antigen-specific models to interrogate the T cell response. Using a chicken egg OVA–expressing S. aureus strain to analyze OVA-specific T cell responses, we demonstrated that primary...
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Due to the high rate of colonization, patients with atopic dermatitis are at risk of S. aureus bloodstream infection, the most severe manifestation of S. aureus infections. Intravascular devices and the skin are the major portals of entry for S. aureus in AD. With prompt and adequate diagnostic and therapeutic management, mortality is lower than in Non-AD patients with SAB and severe sequelae can be averted. Important preventive strategies include AD treatment to reduce S. aureus colonization and meticulous care of intravascular catheters, which should not be placed in/on lesional atopic skin.
Cystic fibrosis (CF), an autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) ion channel, is characterized by abnormal secretions in multiple organ systems and eventual respiratory failure. Significant variation in disease progression exists even among individuals with identical CFTR genotypes. [1 –2] While the impact of gene modifiers continues to be a subject of intense research,  non-genetic factors, such as socioeconomic and environmental exposures, also contribute to this variability,  accounting for approximately 50% of the clinical variation in CF.
Publication date: Available online 17 February 2020Source: Inorganica Chimica ActaAuthor(s): Priyaranjan Kumar, Ray J. Butcher, Ashis K. PatraAbstractHerein, we report physiochemical aspects, crystal structures, biological reactivity and interaction, DNA damage activity and preliminary antimicrobial properties of three metal complexes, [Co/Ni(dppz)2(sac)(H2O)]ClO4 [Co(II), 1; Ni(II), 2] and [Cu(dppz)2(sac)]ClO4 (3), where dppz is dipyrido[3,2-a:2′,3′-c]phenazine as potential photosensitizer and DNA intercalator and sac is artificial sweetener saccharin (o-sulfobenzimide). The solid-state structural analysis rev...
Conclusions: The pattern of airway colonisation in the Indian setting is different from the Caucasian population, and P. aeruginosa and Burkholderia cepacia complex appear early. Colonisation with P. aeruginosa benefits from therapy. In case of infection, care must be taken while initiating empiric therapy. It should be based on local antibiograms to prevent the emergence of resistant microbes.
Interactions in the airway ecology of cystic fibrosis may alter organism persistence and clinical outcomes. Better understanding of such interactions could guide clinical decisions. We used generalized estimating equations to fit logistic regression models to longitudinal 2-year patient cohorts in the Cystic Fibrosis Foundation Patient Registry, 2003 to 2011, in order to study associations between the airway organisms present in each calendar year and their presence in the subsequent year. Models were adjusted for clinical characteristics and multiple observations per patient. Adjusted models were tested for sensitivity to...
ConclusionThere was a high correlation between pretransplant sinus cultures and posttransplant BAL cultures for PsA, MRSA, and Burkholderia sp. This suggests that the paranasal sinuses may act as a reservoir for allograft colonization in patients with cystic fibrosis. Further studies are needed to determine whether treatment of sinusitis affects allograft colonization and transplant outcomes.
Conclusion The prevalence of MRSA has been rising. Since its impact on clinical outcomes, optimal prevention and treatment strategies are unclear, further studies to expand the knowledge about the infection control strategies and MRSA treatment are highly recommended.