CHEST Journal (2021)
Eradicating Pseudomonas Persistence in Adult Patients With Cystic Fibrosis With A New Algorithm Of Antibiotic Selection
Publication Type | Journal article |
Authors | George Tetz
Christina Kardava Maria Vecherkovskaya Victor Tetz |
Abstract | Objectives: Pseudomonas aeruginosa is a common pathogen, causing chronic and life-threatening infections in airways of patients with cystic fibrosis (CF). Multidrug-resistant P.aeruginosa (MDR-PA), is an important cause of persistent infections due to its ability to form biofilms which display tolerance and high resistance to antimicrobial agents Traditional antibiotic selection tests take days and fail to select effective antibiotics against MDR-PA because not accounting for critical characteristics of “real-life” infections. AtbFinder – a novel culture-based test system addresses these realities by using a novel principle of antibiotic selection, named “populational response”, and has previously proved to be highly effective in selecting antibiotics effective even against MDR bacteria in biofilms, delivering results in 4 hours.. Here we present findings from 3-y long microbiological monitoring of P.aeruginosa persistence in patients with CF, that underwent antimicrobial treatment with antiboitics selected using AtbFinder.
Methods: 30 CF patients aged between 18 and 63, with confirmed P.aeruginosa chronic infection, receiving prophylactic antibiotic therapy with antibiotics selected based on AtbFinder results were monitored over 2 years. Sputum was obtained during yearly check-up hospitalisations and the presence of P.aeruginosa was assessed with (i)AtbFinder or (ii) standard microbiological media.Objectives: Pseudomonas aeruginosa is a common pathogen, causing chronic and life-threatening infections in airways of patients with cystic fibrosis (CF). Multidrug-resistant P.aeruginosa (MDR-PA), is an important cause of persistent infections due to its ability to form biofilms which display tolerance and high resistance to antimicrobial agents Traditional antibiotic selection tests take days and fail to select effective antibiotics against MDR-PA because not accounting for critical characteristics of “real-life” infections. AtbFinder – a novel culture-based test system addresses these realities by using a novel principle of antibiotic selection, named “populational response”, and has previously proved to be highly effective in selecting antibiotics effective even against MDR bacteria in biofilms, delivering results in 4 hours.. Here we present findings from 3-y long microbiological monitoring of P.aeruginosa persistence in patients with CF, that underwent antimicrobial treatment with antiboitics selected using AtbFinder. Results: First we analyzed the effect of antibiotic therapy selected with the AtbFinder on eradication of P.aeruginosa. By year 1 and 2 after the switch for the use of antibiotics selected with AtbFinder, eradication of P.aeruginosa were noted in 16 (53%) and 22 (73%) out of 30 subjects who had P.aeruginosa infection respectively (p<0.001) We next studied how antibiotics selected with AtbFinder, affected P.aeruginosa sputum load in patients who were still having P.aeruginosa infection. The mean sputum density of P.aeruginosa following a switch in antibiotic therapy selected based on standard methods to those selected with the AtbFinder from baseline (year 0) decreased by 3.2 and 4.1 log10 CFU/g for P.aeruginosa and at year 1 and 2, respectively. Moreover we were able to switch to narrow-spectrum antibiotics in over than 50% of patients. Conclusion: Antibiotic optimization with AtbFinder results in progressive eradication of P.aeruginosa from airways of patients with CF. |
Year of Publication |
2021 |
Journal | CHEST Journal |
DOI | 10.3390/microorganisms9061301 |