Source: Annual Congress 2009 - Cystic fibrosis: advances in clinical research
Disease area: Respiratory infections

Abstract

Introduction: Longitudinal data on genotypes of P. aeruginosa strains after eradication treatment are limited. We followed CF patients after a first ever PA isolate and evaluated the PA free time period after eradication therapy and the efficacy of treatment, relying on time to subsequent PA isolation and comparison of PA genotypes.
Methods: Between June 2002 and December 2008 sputa or nasopharyngeal aspirates were cultured prospectively from 41 CF patients with a first ever PA isolate. Eradication treatment consisted of oral ciprofloxacin and inhaled tobramycin or colistin for 3 months. Genotyping of the cultured PA isolate was carried out by RAPD-analysis.
Results: Eradication treatment failed in 7 patients, becoming immediately colonized. The first eradication treatment was successful in 34 (83%) patients, of which 19 (56%) had a second PA infection after a median period of 12 months (range 5 - 58 m), with 4 patients becoming chronically colonized after a median time of 13 months (range 5 - 36 m). At present, 15 patients (37%) remain PA free after a median follow-up period of 50 months (range 5 - 63 m).
The 11 patients becoming chronically colonized during the study period had a significantly shorter PA free interval between the first ever and second isolate compared to not chronically colonized patients (p = 0.041) and 10 of the 11 had the same genotype for first and second isolates.
Conclusion: Our findings of eradication success and median time to recurrence after a first positive PA culture were comparable to those of three earlier studies. An identical PA genotype in the second positive culture and a short PA free interval are ominous signs of impending chronic colonization.

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P. Schelstraete, P. Deschaght, L. Van Simaey, S. Van Daele, F. Haerynck, M. Vaneechoutte, F. De Baets (Ghent, Belgium). Genotype based evaluation of eradication treatment for p. aeruginosa infections in CF patients. Eur Respir J 2009; 34: Suppl. 53, 1266

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