Skip to main content
SpringerLink
Log in

Combination antibiotic susceptibility of biofilm-grown Burkholderia cepacia and Pseudomonas aeruginosa isolated from patients with pulmonary exacerbations of cystic fibrosis

  • Brief Report
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

We identified double and triple antibiotic combinations effective against biofilm-grown Burkholderia cepacia and Pseudomonas aeruginosa sampled from cystic fibrosis (CF) patients undergoing acute pulmonary exacerbations. Sputum bacteria from 110 CF patients were grown as biofilms. Combination antibiotic susceptibility testing was used to test 94 double and triple antibiotic combinations. Biofilm-grown bacterial isolates were less susceptible to antibiotic combinations compared to the same bacterial isolates grown planktonically (P < 0.001). Fifty-nine percent of biofilm-grown B. cepacia isolates and 29% of P. aeruginosa isolates were resistant to all double antibiotic combinations tested. Triple antibiotic combinations were more effective than double antibiotic combinations against biofilms (P < 0.0001). For P. aeruginosa biofilms, the addition of azithromycin or rifampin to otherwise effective antibiotic combinations was frequently associated with antagonism. Bacterial biofilms of CF organisms are highly resistant to antibiotics. This study identified potentially effective antibiotic combinations to guide the empirical treatment of CF pulmonary exacerbations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Aaron SD, Vandemheen KL, Ferris W et al (2005) Combination antibiotic susceptibility testing to treat exacerbations of cystic fibrosis associated with multiresistant bacteria: a randomised, double-blind, controlled clinical trial. Lancet 366:463–471

    Article  PubMed  CAS  Google Scholar 

  2. Singh PK, Schaefer AL, Parsek MR et al (2000) Quorum-sensing signals indicate that cystic fibrosis lungs are infected with bacterial biofilms. Nature 407:762–764

    Article  PubMed  CAS  Google Scholar 

  3. Costerton JW, Stewart PS, Greenberg EP (1999) Bacterial biofilms: a common cause of persistent infections. Science 284:1318–1322

    Article  PubMed  CAS  Google Scholar 

  4. Cystic Fibrosis Foundation (1994) Microbiology and infectious disease in cystic fibrosis. Bethesda, Maryland, pp 1–26

    Google Scholar 

  5. Ceri H, Olson ME, Stremick C et al (1999) The Calgary Biofilm Device: new technology for rapid determination of antibiotic susceptibilities of bacterial biofilms. J Clin Microbiol 37:1771–1776

    PubMed  CAS  Google Scholar 

  6. Keays T, Ferris W, Vandemheen KL et al (2009) A retrospective analysis of biofilm antibiotic susceptibility testing: a better predictor of clinical response in cystic fibrosis exacerbations. J Cyst Fibros 8:122–127

    Article  PubMed  CAS  Google Scholar 

  7. Aaron SD, Ferris W, Ramotar K et al (2002) Single and combination antibiotic susceptibilities of planktonic, adherent, and biofilm-grown Pseudomonas aeruginosa isolates cultured from sputa of adults with cystic fibrosis. J Clin Microbiol 40:4172–4179

    Article  PubMed  CAS  Google Scholar 

  8. Caraher E, Reynolds G, Murphy P et al (2007) Comparison of antibiotic susceptibility of Burkholderia cepacia complex organisms when grown planktonically or as biofilm in vitro. Eur J Clin Microbiol Infect Dis 26:213–216

    Article  PubMed  CAS  Google Scholar 

  9. Savoia D, Zucca M (2007) Clinical and environmental Burkholderia strains: biofilm production and intracellular survival. Curr Microbiol 54:440–444

    Article  PubMed  CAS  Google Scholar 

  10. Hoffmann N, Lee B, Hentzer M et al (2007) Azithromycin blocks quorum sensing and alginate polymer formation and increases the sensitivity to serum and stationary-growth-phase killing of Pseudomonas aeruginosa and attenuates chronic P. aeruginosa lung infection in Cftr−/− mice. Antimicrob Agents Chemother 51:3677–3687

    Article  PubMed  CAS  Google Scholar 

  11. Hill D, Rose B, Pajkos A et al (2005) Antibiotic susceptibilities of Pseudomonas aeruginosa isolates derived from patients with cystic fibrosis under aerobic, anaerobic, and biofilm conditions. J Clin Microbiol 43:5085–5090

    Article  PubMed  CAS  Google Scholar 

  12. Slinger R, Chan F, Ferris W et al (2006) Multiple combination antibiotic susceptibility testing of nontypeable Haemophilus influenzae biofilms. Diagn Microbiol Infect Dis 56:247–253

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosures

Laurence Dales has no conflicts of interest to disclose.

Wendy Ferris has no conflicts of interest to disclose.

Katherine Vandemheen has no conflicts of interest to disclose.

Shawn D. Aaron has no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. The Ottawa Health Research Institute, University of Ottawa, Ottawa, ON, Canada

    L. Dales, K. Vandemheen & S. D. Aaron

  2. Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    W. Ferris

  3. Departments of Medicine and Pediatrics, The Ottawa Health Research Institute, University of Ottawa, Ottawa, ON, Canada

    L. Dales, W. Ferris, K. Vandemheen & S. D. Aaron

  4. The Ottawa Hospital, General Campus, Room 1812F, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada

    S. D. Aaron

Authors
  1. L. Dales
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. Ferris
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Vandemheen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. D. Aaron
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. D. Aaron.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dales, L., Ferris, W., Vandemheen, K. et al. Combination antibiotic susceptibility of biofilm-grown Burkholderia cepacia and Pseudomonas aeruginosa isolated from patients with pulmonary exacerbations of cystic fibrosis. Eur J Clin Microbiol Infect Dis 28, 1275–1279 (2009). https://doi.org/10.1007/s10096-009-0774-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-009-0774-9

Keywords

Search

Navigation