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Reinfection, rather than persistent infection, in patients with chronic granulomatous disease
Shireen V Guide1, Frida Stock, Vee J Gill
1Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases and Clinical Research Training Program/NIH, 10 Center Drive, Bethesda, MD 20892, USA.
Abstract:
Chronic granulomatous disease (CGD) is characterized by severe recurrent infections with Staphylococcus aureus, certain gram-negative rods, Nocardia species, and fungi. When infections with the same species recur, they may represent relapses or new infections. We collected organisms from infections that occurred between 1992 and 2000 in patients with CGD and determined the biochemical phenotypes, in vitro antibiotic susceptibility patterns, and pulsed-field gel electrophoresis (PFGE) patterns of the organisms causing the initial and recurrent infections. Recurrence of infection with Burkholderia cepacia or Serratia marcescens was caused by a new strain in 9 of 10 cases (P=.001). Recurrent S. aureus infections were caused by new strains in 7 of 8 cases (P=.006). In patients with CGD, recurrence of infection with the same bacterial species after appropriate antibiotic therapy usually represents new infection.
Insights
Patients with chronic granulomatous disease (CGD) often experience recurrent bacterial infections. Studies show these recurrences are typically new infections rather than relapses, even with the same bacterial species.
Area of Science:
- Immunology
- Infectious Diseases
- Microbiology
Background:
- Chronic granulomatous disease (CGD) predisposes patients to severe, recurrent infections.
- Distinguishing between infection relapse and new infection is crucial for effective management in CGD patients.
Purpose of the Study:
- To investigate whether recurrent infections in CGD patients are typically relapses or new infections.
- To analyze the microbial strains causing initial and recurrent infections in CGD.
Main Methods:
- Collected bacterial isolates from CGD patients experiencing infections between 1992 and 2000.
- Determined biochemical phenotypes, antibiotic susceptibility, and pulsed-field gel electrophoresis (PFGE) patterns.
- Compared strains from initial and subsequent infections.
Main Results:
- Recurrent infections with Burkholderia cepacia or Serratia marcescens were caused by new strains in 90% of cases.
- Recurrent Staphylococcus aureus infections were caused by new strains in 87.5% of cases.
- Statistical analysis indicated a significant difference (P=.001 for B. cepacia/S. marcescens, P=.006 for S. aureus).
Conclusions:
- In patients with CGD, recurrent infections with the same bacterial species usually represent new infections, not relapses.
- This finding has significant implications for treatment strategies and infection control in CGD.
- Understanding the source of recurrent infections is vital for improving patient outcomes.