CST, ELB and JA have no conflicts to report. HRR and MDP have served in the past five years on advisory boards for Novartis and Gilead, and have received research support from Gilead Sciences.
CST was responsible for collection and analysis of all patient related data, assisted ELB in capsular serotyping and developed the manuscript. JA, HRR and MDP were responsible for the conception of the project, supervision of the collection and analysis of patient and microbiologic data, and assisted with writing and revising the manuscript. All authors read and approved the final manuscript.
Cystic fibrosis (CF) is a genetic disease characterized by complex polymicrobial communities within the lower respiratory tract. S. pneumoniae, while a well-defined pathogen in the general population, has rarely been identified in CF. Furthermore, prevalence studies on Pneumococcus in CF have predominantly focused on the infant and pediatric populations, and outcome data is lacking.
Through a review of our comprehensive clinical and microbiologic database from a single adult CF center in Canada from 1978–2013 we sought to determine the incidence, prevalence, serotype and clinical impact of Pneumococcus in adults with CF.
Only fifteen of 318 adult CF patients (5%) were ever found to have transient Pneumococcus colonization, and none developed persistent infection although length of carriage varied. As all isolates were stored, capsular serotyping could be performed using a multiplex PCR panel. Capsular serotyping revealed a varied distribution of several serotypes within these isolates. Lung function testing at time of incident Pneumococcus isolation was compared with values before and after isolation and showed no significant reduction in spirometry values, nor was there an increased need for rescue antibacterial therapy.
Within our center, incident Pneumococcus infection is neither common, associated with a disproportionate clinical deterioration nor results in chronic infection.
Hoiby N. Epidemiological investigations of the respiratory tract bacteriology in patients with cystic fibrosis. Acta Pathol Microbiol Scand B: Microbiol Immunol. 1974;82(4):541–50.
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests;Approved Standard. In: CLSI document M02-A10. 19th ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2009.
Schrag SJB B, Dowell S. Resistant pneumococcal infections: the burden of disease and challenges in monitoring and controlling antimicrobial resistance, Centers for Disease Control and Prevention. Atlanta, GA, United States of America: World Health Organization; 2001.
Registry CCF: 2013 Annual Report. 2013.
VanDevanter DR, Konstan MW. Outcome measures for clinical trials assessing treatment of cystic fibrosis lung disease. Clin Investig. 2012;2(2):163–75. CrossRef
- Prevalence and impact of Streptococcus pneumoniae in adult cystic fibrosis patients: a retrospective chart review and capsular serotyping study
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Erin L Brown
Harvey R Rabin
Michael D Parkins
- BioMed Central
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