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Long Term Chronic Pseudomonas aeruginosa Airway Infection in Mice
Published on: March 17, 2014
Chronic Pseudomonas aeruginosa infection in chronic obstructive pulmonary disease
Laura Martínez-Solano1, María D Macia, Alicia Fajardo
1Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología (Consejo Superior de Investigaciones Cientificas), Cantoblanco, Madrid, Spain.
Background:
Pseudomonas aeruginosa infections are increasingly associated with acute exacerbations in chronic obstructive pulmonary disease (COPD). We aimed to determine whether an underlying chronic infection might be behind this process and to determine the epidemiological characteristics of the isolates involved, to implement useful protocols for preventing and treating these infections.
Methods:
P. aeruginosa isolates obtained from respiratory samples of 13 patients with COPD and from blood samples of 10 patients in intensive care units were investigated. In 8 patients with COPD, isolates were obtained during sequential exacerbation episodes. Five patients presented a single infection episode. Production of virulence determinants and genetic relationships were analyzed in all isolates.
Results:
Patients with COPD were usually infected with 1 P. aeruginosa clone that remained in the lung for years, without evidence of interpatient transmission. During chronic infection, each clone diversified, which led to the coexistence of isolates with different morphotypes and antibiotic susceptibility. Overall, P. aeruginosa evolved toward an increased mutation rate, increased antibiotic resistance, and reduced production of proteases. Isolates from samples of infected lungs tend to be less cytotoxic and motile and to produce more biofilm, compared with isolates from blood samples.
Conclusion:
These results provide the first evidence supporting the hypothesis that P. aeruginosa causes chronic infections in COPD, with patterns of infection and evolution that resemble those observed in cystic fibrosis. Experience gained from treating cystic fibrosis might be useful for implementing new procedures for the prevention, diagnosis, and treatment of infection due to P. aeruginosa in COPD.
Insights
Pseudomonas aeruginosa causes chronic lung infections in chronic obstructive pulmonary disease (COPD) patients. These persistent infections evolve, developing antibiotic resistance and biofilm production, similar to cystic fibrosis patterns.
Area of Science:
- Medical Microbiology
- Pulmonology
- Infectious Diseases
Background:
- Pseudomonas aeruginosa infections are linked to acute exacerbations in chronic obstructive pulmonary disease (COPD).
- The role of chronic infection in this association requires further investigation.
- Understanding the epidemiology of these isolates is crucial for effective management.
Purpose of the Study:
- To determine if chronic Pseudomonas aeruginosa infection underlies COPD exacerbations.
- To characterize the epidemiological features of involved Pseudomonas aeruginosa isolates.
- To inform prevention and treatment strategies for these infections.
Main Methods:
- Analysis of Pseudomonas aeruginosa isolates from respiratory samples of COPD patients and blood samples from ICU patients.
- Investigation of sequential exacerbation episodes in COPD patients.
- Assessment of virulence determinant production and genetic relationships among isolates.
Main Results:
- COPD patients were typically infected with a single, long-term Pseudomonas aeruginosa clone, with no evidence of interpatient transmission.
- Chronic infection led to clone diversification, resulting in varied morphotypes and antibiotic susceptibility.
- Pseudomonas aeruginosa evolved increased mutation rates, antibiotic resistance, and reduced protease production, with lung isolates favoring biofilm formation over cytotoxicity.
Conclusions:
- First evidence suggests Pseudomonas aeruginosa establishes chronic infections in COPD, mirroring patterns seen in cystic fibrosis.
- Insights from cystic fibrosis management may guide new approaches for Pseudomonas aeruginosa infection prevention, diagnosis, and treatment in COPD.
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