Increased Prevalence and Resistance of Important Pathogens Recovered from Respiratory Specimens of Cystic Fibrosis Patients During a Decade. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Raidt, Lena; Idelevich, Evgeny A.; Dübbers, Angelika; Küster, Peter; Drevinek, Pavel; Peters, Georg; Kahl, Barbara C.
• Is Part Of: Pediatric infectious disease journal. Volume 34:Issue 7(2015)
• Publication Date: 2015-07
• Subjects: Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000000714
• Languages: English
• ISSNs: 0891-3668

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>The study objective was to identify changes of prevalence and resistance of important pathogens in specimens of cystic fibrosis (CF) patients within a decade.</p> </sec> <sec> <title>Methods:</title> <p>Samples of 94 patients, who attended 2 CF centers from 2001 to 2011 were retrospectively analyzed.</p> </sec> <sec> <title>Results:</title> <p> <italic>Staphylococcus aureus</italic> was the most prevalent organism (74.5% in 2011) with an increase of methicillin-resistant <italic>S. aureus</italic> in patients (0% vs. 9.6%, n = 9). Resistance of <italic>S. aureus</italic> to gentamicin decreased (41.8% vs. 21%; <italic>P</italic> < 0.001), whereas resistance to rifampicin and trimethoprim/sulfamethoxazole (<italic>P</italic> < 0.05) increased significantly with a trend to increased resistance to clindamycin and erythromycin (<italic>P</italic> = 0.063). Methicillin-resistant <italic>S. aureus</italic> isolates belonged to 6 <italic>spa</italic> types (t003, t008, t011, t034, t045, t548). There was a significant increase of <italic>Pseudomonas aeruginosa</italic> prevalence (63.8% in 2011 vs. 46.8% in 2001, <italic>P</italic> = 0.019). Resistance of <italic>P. aeruginosa</italic> increased significantly to imipenem, gentamicin, amikacin, tobramycin, ciprofloxacin and fosfomycin, whereas resistance to piperacillin–tazobactam, meropenem and aztreonam decreased. Significantly fewer <italic>Stenotrophomonas maltophilia</italic> isolates were susceptible to all the analyzed antibiotics (trimethoprim/sulfamethoxazole, ciprofloxacin and colistin) in 2011 compared with 2001 (13.5% vs. 42.1%; <italic>P</italic> = 0.023), whereas the resistance to colistin increased significantly (11.1% vs. 62.2%; <italic>P</italic> < 0.001). <italic>Burkholderia cepacia</italic> complex and nontuberculous mycobacteria were not detected in 2001 but in 2011 in 7.4% (n = 9) and 7.4% (n = 9) of patients, respectively. <italic>B. cepacia</italic> complex isolates belonged to 8 multilocus sequence types.</p> </sec> <sec> <title>Conclusions:</title> <p>Our retrospective analysis revealed an increase of important CF-related pathogens, the emergence of new pathogens and a substantial increase of multidrug-resistant CF-specific isolates. Our findings are of importance to clinicians for the alertness of local epidemiology, which may be useful for prevention and treatment strategies.</p> </sec> </abstract>