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PubMed1983

In vitro assessment of combined antibiotic and mucolytic treatment for Pseudomonas aeruginosa infection in cystic fibrosis.

The minimal inhibitory concentration of azlocillin for Pseudomonas aeruginosa is appreciably reduced when combined with the mucolytic agent mesna (Mistabron) because of an independent bacteriostatic effect of mesna. Bactericidal activity of azlocillin is unaltered by mesna. Mesna inhalations alone or combined with azlocillin may benefit cystic fibrosis patients with pseudomonas lung infections.

Azlocillin↗
PubMedDate not supplied

Endogenous and exogenous infection with Pseudomonas aeruginosa in a burns unit.

Twenty patients who were admitted to the Burns Unit from December, 1969 through October, 1970 were studies to determine the sources of infection caused by Pseudomonas aeruginosa. The pyocine typing method was employed for finger printing of 383 isolates recovered from wounds and 67 isolates from environmental cultures of nurses' hands, sinks, floors, bed rails, walls and baths. In addition, cultures of moist rectal swabs were carried out daily for the first six days of hospitalization to assess the importance of endogenous infection. In six patients, the rectum was identified as the source of infection. However, in these patients, pyocine types of Ps. aeruginosa which were not obtained from rectal cultures, were also recovered. Pyocine types 1b, 10 and 31 were isolated more frequently than others. Clustering of common pyocine types suggests cross-contamination. Sinks were found to be consistently contaminated with Ps. aeruginosa. Amongst the environmental sources, positive cultures were occasionally obtained from floors, bed rails and nurses' hands. It is suggested that sinks are probably the most important reservoir of Pseudomonas infection in burns.

Burn Units↗
PubMed1998

Epidemiology and clinical impact of Pseudomonas aeruginosa infection in cystic fibrosis using AP-PCR fingerprinting.

Arbitrarily primed PCR (AP-PCR) was utilized to genetically fingerprint 252 Pseudomonas aeruginosa strains isolated from the sputa of 50 cystic fibrosis (CF) patients attending the Cork CF clinic over a period of 3 years. Ten distinct P. aeruginosa strains were identified and the distribution, temporal trends and clinical impact of colonization with these individual P. aeruginosa clones was studied. A number of random isolates from each AP-PCR group were analysed using pulsed field gel electrophoresis (PFGE) in order to confirm the discriminatory power of the AP-PCR technique. The majority of patients were colonized with a single strain over the time period of the study, but it was also possible to harbour two or more strains transiently or simultaneously. Four main strains were relatively evenly distributed throughout the CF population, and it was noted that patients from the same family or attending the same school tended to harbour the same P. aeruginosa clone. Disease severity was significantly associated with the age of the patient (P < 0.001), clearly indicating an increase in severity with increase in age. The general clinical status of the CF patients was not significantly associated with the P. aeruginosa variant isolated from their sputa. Lung status was defined by FEV1 measurement and chest X-ray score (CXR). The non parametric Kruskal-Wallis significance test of FEV1, CXR and age by colonizing P. aeruginosa clone indicated that FEV1 (P = 0.017), but not CXR (P = 0.19) or age (P = 0.842), differed significantly across the clones of P. aeruginosa isolated. Patients harbouring P. aeruginosa strains B, F or G clearly had lower FEV1 scores while those harbouring clones A, C, D or H generally had higher FEV1 scores. Thus, the sub-species variant of P. aeruginosa colonizing CF patients may be associated with the severity of progressive lung disease.

Adult↗
PubMed1987

Diagnosis of chronic Pseudomonas aeruginosa infection in cystic fibrosis by enzyme-linked immunosorbent assay.

An easily applicable test for diagnosis of chronic Pseudomonas aeruginosa infection in cystic fibrosis by enzyme-linked immunosorbent assay (ELISA) for determination of serum immunoglobulin G to P. aeruginosa was developed. Soluble antigens obtained by ultrasonication of P. aeruginosa, serotypes O:1 to O:17, were used as antigens immobilized to polystyrene microtiter plates. The intraplate, plate-to-plate, and day-to-day variations were 14, 19, and 20%, respectively. Plates coated with the antigens could be stored for at least 64 days at +4 and +22 degrees C without any significant change in activity. Normal values were determined in sera from 164 controls (100 children and 64 adults). The sensitivity and specificity of the ELISA was determined by using serum samples from 243 cystic fibrosis patients and were compared to results with crossed immunoelectrophoresis (CIE). The ELISA could diagnose chronic P. aeruginosa infection with a diagnostic sensitivity of 93% and specificity of 92%. The sensitivity and specificity for the diagnosis of the early stages of chronic P. aeruginosa infection by a single sample were 90 and 100%, respectively, and by using an increased antibody response in paired samples, the sensitivity was 93% and specificity was 87%. There was a statistically significant correlation between antibody levels obtained by ELISA and those obtained by CIE. The sensitivity and specificity of the ELISA were equal to those of CIE, and because of its simplicity, the ELISA is recommended as a routine test in patients with cystic fibrosis.

Adolescent↗
PubMed1992

Role of chronic Pseudomonas aeruginosa infection in the development of bronchiectasis.

To understand the role of Pseudomonas aeruginosa infection in the development of bronchiectasis, we investigated by CT the presence of bronchiectasis in two groups of chronic bronchitis patients and in a control group. There were no differences in clinical or laboratory findings between groups A and B. Three observers without any knowledge of these patients reported bronchiectasis on a scale of 0 to 3 and bronchial wall thickness on a scale of 0 to 3 in each lobe of both lungs. Bronchiectasis and wall thickness scores in group A (chronic bronchitis with P aeruginosa infection) were significantly higher than bronchiectasis scores and wall thickness in group B (chronic bronchitis without P aeruginosa infection). Both scores in group B were higher than those in group C (control group). These findings support the idea that chronic P aeruginosa infection plays a role in the development of bronchiectasis.

Adult↗
PubMed1980

Gentamicin and tobramycin compared in the treatment of mucoid pseudomonas lung infections in cystic fibrosis.

18 children with cystic fibrosis and mucoid pseudomonas lung infection were treated with courses either of gentamicin plus carbenicillin, or tobramycin plus carbenicillin, with 2 children each receiving two courses. 10 courses of gentamicin at a dose of 9 mg/kg per day plus carbenicillin at 800 mg/kg per day, and 10 courses of tobramycin at 9 mg/kg per day plus carbenicillin at 800 mg/kg per day were given. There was clinical and x-ray improvement in both groups of children, but there was no difference between the therapeutic benefit of either regimen. Pseudomonas aeruginosa was not cultured at the end of treatment after 15 of the 20 courses, but it returned in all but one patient within 3 months. Neither ototoxicity nor renal damage with these high doses of aminoglycoside was detected. P. aeruginosa had not been eliminated when 9 of these patients earlier had received courses of gentamicin in a dose of 6 mg/kg per day plus carbenicillin at 800 mg/kg per day. The results show that P. aeruginosa can successfully be eliminated or suppressed with high-dose aminoglycoside plus carbenicillin, but such elimination is usually short lived.

Adolescent↗
PubMed2006

Identification of optimal combinations for empirical dual antimicrobial therapy of Pseudomonas aeruginosa infection: potential role of a Combination Antibiogram.

To better determine the optimal combinations for empirical dual antimicrobial therapy of Pseudomonas aeruginosa infection, we evaluated the utility of a novel combination antibiogram. Although the combination antibiogram allowed modest fine-tuning of choices for dual antibiotic therapy, selections based on the 2 antibiograms did not differ substantively. Drug combinations with the broadest coverage were consistently composed of an aminoglycoside and a beta-lactam.

Anti-Bacterial Agents↗