Summary
Xanthomonas maltophilia was isolated from 25 of 150 patients with cystic fibrosis during a period of 10 years (1983–1992). Twelve patients harbouredX. maltophilia chronically, i.e. repeatedly for more than 6 months. No predisposing factors for the colonisation could be identified by studying the clinical and laboratory data of the patients, including preceding and concurrent bacterial colonisation with other bacteria, antibacterial treatments, pulmonary function and biochemical markers. Up to 2 years after the chronic colonisation was established no clinical deterioration could be verified, but the patients withX. maltophilia generally had a worse lung function at the latest follow-up (2–7 years after colonisation) than controls colonised withPseudomonas aeruginosa (p<0.05). Our data imply thatX. maltophilia is a pathogen and the colonisation appears to follow the same pattern as the colonisation byP. aeruginosa. The development of resistance to different antibiotics, as revealed by analysis of the inhibition zones, was related to antibacterial treatment courses.X. maltophilia showed reduced sensitivity to the most commonly used antibiotics, ceftazidime and tobramycin.
Zusammenfassung
Xanthomonas maltophilia wurde bei 25 von 150 Patienten während eines Zeitraumes von 10 Jahren (1983–1992) isoliert. 12 Patienten hatten eine chronische Kolonisierung, das heißt bestehend während mehr als 6 Monaten. Prädisponierende Faktoren konnten bei der Analyse der klinischen Daten und Labordaten nicht festgestellt werden, frühere und gleichzeitige Kolonisierung mit anderen Bakterien, Lungenfunktion und biochemische Parameter inbegriffen. Bis zu 2 Jahre nachdem die chronische Kolonisierung etabliert worden war, fanden wir keine klinische Verschlechterung. Die langfristige Verlaufskontrolle (2–7 Jahre) zeigte, daß Patienten mitX. maltophilia meistens eine schlechtere Lungenfunktion hatten als Kontrollfälle, die mitPseudomonas aeruginosa kolonisiert worden waren (p<0,05). Unsere Daten deuten an, daß bei Patienten mit zystischer FibroseX. maltophilia ein pathogener Erreger ist und die Kolonisierung nach demselben Muster zu erfolgen scheint wie die Kolonisierung mitP. aeruginosa. Die Entwicklung der Antibiotikaresistenz wurde durch Bestimmung der Hemmzonen im Verhältnis zu Antibiotikabehandlungen verfolgt.X. maltophilia zeigte eine herabgesetzte Empfindlichkeit gegen die meisten Antibiotika. In unserer Serie gab es eine markante Resistenzentwicklung gegen Ceftazidim und Tobramycin während der chronischen Kolonisierung.
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References
Gilligan, P. H. Microbiology of airway disease in patients with cystic fibrosis. Clin. Microbiol. Rev. 4 (1991) 35–51.
Valerius, N. H., Koch, C., Høiby, N. Prevention of chronicPseudomonas aeruginosa colonization in cystic fibrosis by early treatment. Lancet 338 (1991) 725–726.
Morrison, A. J., Hoffmann, K. K., Wenzel, R. P. Associated mortality and clinical characteristics of nosocomialPseudomonas maltophilia in a university hospital. J. Clin. Microbiol. 24 (1986) 52–55.
Mett, H., Rosta, S., Schacher, B., Frei, R. Outer membrane permeability and beta-lactamase content inPseudomonas maltophilia clinical isolates and laboratory mutants. Rev. Inf. Dis. 10 (1988) 765–769.
Elting, L. S., Bodey, G. P. Septicaemia due toXanthomonas species and non-aeruginosaPseudomonas species: Increasing incidence of catheter-related infections. Medicine 169 (1990) 296–306.
Elting, L. S., Khardori, N., Bodey, G. P., Fainstein, V. Nosocomial infections caused byXanthomonas maltophilia: a case-control study of predisposing factors. Infect. Control Hosp. Epidemiol. 11 (1990) 134–138.
Whishart, M. M., Riley, T. V. Infection withPseudomonas maltophilia: hospital outbreak due to contaminated disinfectant. Med. J. Austr. 2 (1976) 710–712.
Klinger, J. D., Thomassen, M. J. Occurrence and antimicrobial susceptibility of gram-negative nonfermentative bacilli in cystic fibrosis patients. Diagn. Microbiol. Inf. Dis. 3 (1985) 149–158.
Baltimore, R. S., Radnay-Baltimore, K., von Graevenitz, A., Dolan, T. F. Occurrence of nonfermentative gram-negative rods other thanPseudomonas aeruginosa in the respiratory tract of children with cystic fibrosis. Helv. Pediatr. Acta 37 (1982) 547–554.
Bauernfeind, A., Bertele, R. M., Harms, K., Hörl, G., Jungwirth, R. Petermüller, C., Pryzklenk, B., Weisslein-Pfister, C. Qualitative and quantitative microbiological analysis of sputa of 102 patients with cystic fibrosis. Infection 15 (1987) 270–277.
Gladman, G., Connor, P. J., Williams, R. F., David, T. J. Controlled study ofPseudomonas cepacia andPseudomonas maltophilia in cystic fibrosis. Arch. Dis. Child 67 (1992) 192–195.
Blessing, J., Walker, J., Maybury, B., Yeager, A. S., Lewiston, N. Pseudomonas cepacia andmaltophilia in the cystic fibrosis patient (abstr.) Am. Rev. Respir. Dis. 4 (1979) 262.
Strandvik, B. Antibiotic therapy of pulmonary infections in cystic fibrosis. Dosage and dose schedules. Chest 94 (1988) 146–149.
Build Study, 1979 In: Geigy Scientific Tables. Ciba-Geigy, Basle 1984, vol. 3. p. 325.
Ericsson-Hollsing, A., Granström, M., Strandvik, B. Prospective study of serum staphylococcal antibodies in cystic fibrosis. Arch. Dis. Child 62 (1987) 905–911.
Kalin, M., Lindberg, A. A., Tunewall, G. Etiological diagnosis of bacterial pneumonia by Gram stain and quantitative culture of expectorates. Scand. J. Inf. Dis. 15 (1983) 153–160.
Gilljam, H., Malmborg, A. S., Strandvik, B. Conformity of bacterial growth in sputum and contamination free endobronchial samples in patients with cystic fibrosis. Thorax 41 (1986) 641–646.
Ericsson, H. M., Sherris, J. C. Antibiotic sensitivity testing. Report of an international collaborative study. Acta Pathol. Microbiol. Scand. 217 (Suppl.) (1971) 1–90.
The Swedish Reference Group for Antibiotics Antimicrobial susceptibility testing of bacteria. National Bacteriological Laboratory, Stockholm, 1990.
Marshall, W. F., Keating, M. R., Anhalt, J. P., Steckelberg, J. M. Xanthomonas maltophilia: an emerging nosocomial pathogen. Mayo Clin. Proceed. 64 (1989) 1097–1104.
Neu, H. C., Saha, G., Chin, N. X. Resistance ofXanthomonas maltophilia to antibiotics and the effect of beta-lactamase inhibitors. Diagn. Microbiol. Infect. Dis. 12 (1989) 283–285.
Khardori, N., Reuben, A., Rosenbaum, B., Rolston, K., Bodey, G. P. In vitro susceptibility ofXanthomonas maltophilia to newer antibiotic agents. Antimicrob. Agents Chemother. 34 (1990) 1609–1610.
Edmonds, C., Griffen, G. E., Johnstone, A. P. Demonstration and partial characterization of ADP-ribosylation inPseudomonas maltophilia. Biochem. 261 (1989) 113–118.
Ericsson-Hollsing, A., Granström, M., Vasil, M. L., Wretlind, B., Strandvik, B. Prospective study of serum antibodies toPseudomonas aeruginosa exoproteins in cystic fibrosis. J. Clin. Microbiol. 25 (1987) 1868–1874.
Hollsing, A. E., Lantz, B., Bergström, K., Malmborg, A. S., Strandvik, B. Granulocyte elastase-α1-antiproteinase complex in cystic fibrosis: sensitive plasma assay for monitoring pulmonary infections. J. Pediatr. 11 (1987) 206–211.
Strandvik, B., Hollsing, A., Möllby, R., Granström, M. Antistaphylococcal antibodies in cystic fibrosis. Infection 18 (1990) 170–172.
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Karpati, F., Malmborg, A.S., Alfredsson, H. et al. Bacterial colonisation withXanthomonas maltophilia — A retrospective study in a cystic fibrosis patient population. Infection 22, 258–263 (1994). https://doi.org/10.1007/BF01739911
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DOI: https://doi.org/10.1007/BF01739911