Epidemiology and natural history ofPseudomonas aeruginosaairway infections in non-cystic fibrosis bronchiectasis Conference Paper uri icon

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abstract

  • The natural history and epidemiology ofPseudomonas aeruginosainfections in non-cystic fibrosis (non-CF) bronchiectasis is not well understood.As such it was our intention to determine the evolution of airway infection and the transmission potential ofP. aeruginosain patients with non-CF bronchiectasis.A longitudinal cohort study was conducted from 1986–2011 using a biobank of prospectively collected isolates from patients with non-CF bronchiectasis. Patients included were ≥18 years old and had ≥2 positiveP. aeruginosacultures over a minimum 6-month period. All isolates obtained at first and most recent clinical encounters, as well as during exacerbations, that were morphologically distinct on MacConkey agar were genotyped by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). A total of 203 isolates from 39 patients were analysed. These were compared to a large collection of globally epidemic and local CF strains, as well as non-CF isolates.We identified four patterns of infection in non-CF bronchiectasis including: 1) persistence of a single strain (n=26; 67%); 2) strain displacement (n=8; 20%); 3) temporary disruption (n=3; 8%); and 4) chaotic airway infection (n=2; 5%). Patterns of infection were not significant predictors of rates of lung function decline or progression to end-stage disease and acquisition of new strains did not associate with the occurrence of exacerbations. Rarely, non-CF bronchiectasis strains with similar pulsotypes were observed in CF and non-CF controls, but no CF epidemic strains were observed. While rare shared strains were observed in non-CF bronchiectasis, whole-genome sequencing refuted patient–patient transmission.We observed a higher incidence of strain-displacement in our patient cohort compared to those observed in CF studies, although this did not impact on outcomes.

authors

  • Woo, Taylor E
  • Lim, Rachel
  • Surette, Michael
  • Waddell, Barbara
  • Bowron, Joel C
  • Somayaji, Ranjani
  • Duong, Jessica
  • Mody, Christopher H
  • Rabin, Harvey R
  • Storey, Douglas G
  • Parkins, Michael D

publication date

  • April 2018