Background
Methods
Results
Case identification
Patient | Year isolated | Location of acquisition | Country of residence | Age | Gender | CFTR Mutation | FEV1% | BMI | Co-pathogens | ETOH >40 g daily | Diabetes |
---|---|---|---|---|---|---|---|---|---|---|---|
1 (O’Carroll, 2003) [12] | 1987 | Northern Australia | Australia | 21 | M | F508del/F508del | 49 | 21 | Pseud | No | No |
2 | Early 1990’s | Northern Australia | Australia | 40 | M | F508del/R117 | 44.5 | 23 | Pseud | Yes | No |
Mycobacterium intracellulare
| |||||||||||
3 (Schülin, 2001) [14] | 1992 | Likely Thailand | Germany | 31 | M | Unknown | Unknown | Unknown | Unknown | Unknown | Unknown |
4 (Visca, 2001) [15] | 1998 | South-East Asia | Italy | 25 | F | Unknown | Unknown | Unknown | Pseud | Unknown | Unknown |
BCp | |||||||||||
5 (Dance, 1999) [11] | 1998 | Malaysia | England | 20 | M | Unknown | Unknown | Unknown | Unknown | Unknown | Unknown |
6 (Holland, 2002) [16] | 1999 | Northern Australia | New Zealand | 8.5 | M | G551D/1717-16 > A | 46 | 15 | Pseud | No | No |
Aspergillus fumigatus
| |||||||||||
7 (Holland, 2002) [16] | 2000 | Northern Australia | New Zealand | 7 | F | G551D/1717-16 > A | Unknown | 19 |
Haemophilus influenzae
| No | No |
Staph A | |||||||||||
8 (O’Carroll, 2003) [12] | 2000 | Northern Australia | Australia | 21 | M | F508del/F508del | 35 | 22 | Pseud | No | Yes |
Staph A | |||||||||||
BCp | |||||||||||
9a (Holland, 2002) [16] | 2000 | Northern Australia | Australia | 18 | M | F508del/F508del | 45 | 21 | Pseud | Yes | No |
Staph A | |||||||||||
BGl | |||||||||||
Mycobacterium intracellulare
| |||||||||||
Other | |||||||||||
10 (O’Carroll, 2003) [12] | 2001 | Northern Australia | Australia | 14 | M | F508del/G542X | 80 | 17 | Pseud | No | No |
Staph | |||||||||||
11 (Holland, 2002) [16] | 2001 | Northern Australia | New Zealand | 38 | M | F508del/F508del | 36 | 19 | Pseud | No | IFG |
Staph A | |||||||||||
12 (O’Carroll, 2003) [12] | 2001 | Northern Australia | Australia | 25 | F | Unknown | 80 | 20 | Pseud | No | No |
Staph A | |||||||||||
BCp | |||||||||||
13 (Asiah, 2006) [8] | 2004 | Malaysia | Malaysia | 17 | M | Unknown | Unknown | Unknown | Pseud | Unknown | Unknown |
Staph A | |||||||||||
14 (Barth, 2007) [9] | 2005 | Brazil | Brazil | 17 | F | Unknown | Unknown | Unknown | Pseud | Unknown | Unknown |
Staph A | |||||||||||
15 | 2005 | Thailand | England | 30 | F | Unknown | 56 | 21 | Pseud | No | Yes |
Staph A | |||||||||||
Aspergillus fumigatus
| |||||||||||
16 (Corral, 2008) [10] | 2006 | British Virgin Islands | England | 17 | M | F508del/E60X | 63 | 22 | Pseud | Unknown | No |
Staph A | |||||||||||
Canada | |||||||||||
17 | 2007 | Northern Australia | Australia | 38 | M | F508del/F711 + 5G > A | 29 | 19 | Pseud | No | No |
Staph A | |||||||||||
Aspergillus terreus
| |||||||||||
18 | 2007 | Thailand | New Zealand | 10 | F | F508del/17aa + IG74 | 107 | 16 | Pseud | No | No |
Staph A | |||||||||||
Other | |||||||||||
19 | 2008 | Thailand | Australia | 22 | F | F508del/F508del | 85 | 23 | Pseud | Yes | Yes |
20 (O’Sullivan, 2011) [13] | 2009 | Aruba | USA | 7 | F | F508del/F508del | 88 | 13 | None | No | No |
21 | 2010 | Vietnam/Cambodia | England | 23 | F | F508del/F508del | 44 | 19 | Pseud | No | No |
Haemophilus influenzae
| |||||||||||
22 (Radhakrishna, 2014) [17] | 2011 | Thailand | Australia | 25 | M | Unknown | 95 | 24 | Pseud | Unknown | No |
Aspergillus fumigatus
| |||||||||||
23 | 2012 | Malaysia/Philippines | Malaysia | 19 | M | R553X/unknown | 18 | 17 | Pseud | No | No |
24 | 2013 | Thailand/Japan | England | 30 | M | F508del/E60X | 67 | 23 | Pseud | No | No |
25 | 2015 | Thailand | England | 21 | F | F508del/F508del | 71 | 18 | Pseud | No | No |
Staph A |
Epidemiology and risk factors for B. Pseudomallei acquisition
Clinical and radiological manifestations of infection with B. Pseudomallei
Long-term outcomes following infection with B. Pseudomallei
Patient | Duration of infection | Year of acquisition | Eradication attempted | Eradication successful | Outcome |
---|---|---|---|---|---|
1 (O’Carroll, 2003) [12] | >15 years | 1987 | No | N/A | Slow decline in lung health consistent with CF; transplant 2004 |
10 (O’Carroll, 2003) [12] | 11 years | 2001 | No | N/A | Slow decline in lung health consistent with CF |
3 (Schülin, 2001) [14] | >9 years | 1992 | Yes | No | Increased frequency of exacerbations |
15 | >8 years | 2005 | Yes | No | Accelerated decline; transplant declined due to B. pseudomallei infection; B. pseudomallei septicaemia;a died 2009 |
22 (Radhakrishna, 2014) [17] | 7 years | 2011 | Yes | Yes | No obvious clinical impact |
2 | 7 years | Early 1990’s | No | N/A | Spontaneously clearance of infection after approx. 7 years; 11 years later died of neutropenic sepsis complicating treatment of Duke’s C colon cancer. |
7 (Holland, 2002) [16] | >6 years | 2000 | Yes | No | Accelerated decline with increased frequency of exacerbations; B. pseudomallei septicaemia; died 2009 |
17 | 6 years | 2007 | No | N/A | Slow decline in lung health consistent with CF |
18 | 6 years | 2007 | Yes | No | Accelerated decline; transplant declined due to B. pseudomallei; died 2013 |
11 (Holland, 2002) [15] | 5 years | 2001 | Yes | No | Accelerated decline; transplant 2006; died 2011 |
23 | >12 months | 2012 | Yes | No | Progressive destruction right upper lobe |
6 (Holland, 2002) [16] | >4 years | 1999 | Yes | No | After presumed latency of 4 years developed accelerated decline with pneumonia; died 2004 |
24 | 4 years | 2009 | Yes | Unknown | Fall in lung function; stable after targeted antimicrobial therapy |
14 (Barth, 2007) [9] | >2 years | 2005 | Yes | No | Accelerated decline with rapid decrease in lung function and recurrent exacerbations over 2 years; long term outcome unknown |
8 (O’Carroll, 2003) [12] | 2 years | 2000 | Yes | No | Rapid decline post infection; died 2 years after initial infection |
21 | 2 years | 2010 | Yes | No | Accelerated decline; transplant 2012 with persistent infection post-transplant |
12 (O’Carroll, 2003) [12] | 2 years | 2001 | Yes | Yes | Repeated admissions with pneumonia, treated with 3 week courses of ceftazidime, meropenem, tobramycin; infection ultimately spontaneously cleared |
4 (Visca, 2001) [15] | 1 year | 1998 | Yes | Yes | Deteriorating pulmonary sepsis, increasingly refractory to anti-pseudomonal antibiotics; cleared infection with antimicrobial therapy; still alive 2013 |
13 (Asiah, 2006) [8] | 1 year | 2004 | Yes | Yes | Increased pulmonary sepsis during infection with B. pseudomallei; remained well 5 months after completing targeted anti-microbial therapy |
Eradication strategies
Patient | Duration of infection prior to treatment | Induction | Consolidation | ||
---|---|---|---|---|---|
Treatment | Duration | Treatment | Duration | ||
Successful eradication | |||||
16 (Corral, 2008) [10] | Unknown – lived in BVI | Meropenem 2 g tds | 19 days | TMP/SMX 960 mg bd | 19 days |
Minocycline 100 mg bd | |||||
Minocycline 100 mg bd | |||||
Tobramycin (neb)a 80 mg bd | |||||
20 (O’Sullivan, 2011) [13] | 3 months | Imipenem | 14 days | Meropenem (neb) | 28 days |
Ceftazidime | TMP/SMX 960 mg bd | 2 years | |||
4 (Visca, 2001) [15] | 12 months | Ceftazidime | 42 days | TMP/SMX 960 mg bd | 210 days |
TMP/SMX 960 mg bd | Doxycycline | ||||
Chloramphenicol | |||||
13 (Asiah, 2006) [8] | 12 months | Ceftazidime | 56 days | TMP/SMX 960 mg bd | 112 days |
TMP/SMX 960 mg bd | Doxycycline | ||||
22 (Radhakrishna, 2014) [17] | 7 years | Meropenem 2 g tds | Approx 56 days | Doxycycline followed by amoxycillin/clavulanic acid (doxycycline allergy) | 12 months |
Ceftazidime 3 g tds | |||||
Tobramycin (neb) 80 mg bd | |||||
TMP/SMX 960 mg bd | |||||
9 (Holland, 2002) [16] Infection 1 | Unknown | Ceftazidime | 14 days | TMP/SMX 960 mg bd | 90 days |
TMP/SMX 960 mg bd | |||||
9 (Holland, 2002) [16] Infection 2 | 1 month | Ceftazidime | 21 days | TMP/SMX 960 mg bd | 90 days |
TMP/SMX 960 mg bd | |||||
9 (Holland, 2002) [16] Infection 3 | 1-2 months | Ceftazidime | 14 days | TMP/SMX 960 mg bd | 90 days |
TMP/SMX 960 mg bd | |||||
Failed Eradication | |||||
8 (O’Carroll, 2003) [12] | 4 months | Meropenem 2 g tds | 56 days | None | |
Ceftazidime 3 g tds | |||||
17 | 6-12 months | Ceftazidime 3 g tds | 14 days | TMP/SMX 960 mg bd | 84 days |
TMP/SMX 960 mg bd | |||||
23 | >10 months | Ceftazidime 3 g tds | 21 days | Unknown (patient moved to Malaysia) | |
TMP/SMX 960 mg bd | |||||
Tobramycin 5 mg/kg | |||||
3 (Schülin, 2001) [14] | 6 years | Unspecified antipseudomonal antibiotics | 14 days | No (exacerbations directed against PsA) | |
14 (Barth, 2007) [9] | >18 months | Pipracillin/clavulanate | 21 days | Meropenem 2 g tds | 21 days |
Tobramycin 5 mg/kg | Ceftazidime 3 g tds | ||||
Amikacin | |||||
TMP/SMX 960 mg bd | |||||
15 | >8 years | Meropenem 2 g tds | 14 days | TMP/SMX 960 mg bd | 126 days |
Tobramycin | Minocycline 100 mg bd | ||||
Meropenem (neb) | |||||
18 (1st attempt) | 2 months | Ceftazidime 1.5 g tds | 14 days | Infection not cleared therefore 2nd course of IV antibiotics | |
Tobramycin 300 mg | |||||
Amoxycillin/Clavulanic acid 900 mg | |||||
18 (2nd attempt) | 2 months | Meropenem | 84 days | TMP/SMX 960 mg bd | Long term |
Ceftazidime | Doxycycline | ||||
Amoxycillin/Clavulanic acid | |||||
6 (Holland, 2002) [16] | >4 years | Ceftazidime 50 mg/kg | 120 days | None (exacerbations directed against B. pseudomallei) | |
Piperacillin 50 mg/kg | |||||
Amoxycillin/Clavulanic acid | |||||
7 (Holland, 2002) [16] | >5 years | TMP/SMX 960 mg bd | 4 years | ||
1st isolation | |||||
7 (Holland, 2002) [16] | >9 years | Imipenem | 20 days | TMP/SMX 960 mg bd | 19 days |
2nd isolation | Piperacillin/Clavulanic acid | 42 days | Tetracycline | 30 days | |
Meropenem/TMP/SMX | >30 days | ||||
11 (Holland, 2002) [16] | 3 months | Ceftazidime | 14 days | TMP/SMX 960 mg bd | 330 days |
Tobramycin | |||||
21 | 1 month | Meropenem 2 g tds | 42 days | Tobramycin (neb) 300 mg bd | 42 days |
Ceftazidime 3 g tds | TMP/SMX 960 mg bd | ||||
Tobramycin 7 mg/kg |