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Stenotrophomonas maltophilia in cystic fibrosis: serologic response and effect on lung disease

Valerie Waters1, Yvonne Yau, Sudha Prasad

  • 1Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada. valerie.waters@sickkids.ca

American Journal of Respiratory and Critical Care Medicine
|October 5, 2010
PubMed
Abstract

Insights

Chronic Stenotrophomonas maltophilia infection in cystic fibrosis (CF) patients triggers an immune response. This chronic infection independently increases the risk of pulmonary exacerbations, impacting lung disease severity.

Area of Science:

  • Medical Microbiology
  • Pulmonology
  • Immunology

Background:

  • Stenotrophomonas maltophilia is a common multidrug-resistant organism in cystic fibrosis (CF) respiratory tracts.
  • The impact of chronic S. maltophilia infection on CF lung disease progression remains unclear.

Purpose of the Study:

  • To investigate the effect of chronic S. maltophilia infection on lung disease in patients with CF.
  • To establish a validated definition for chronic S. maltophilia isolation.

Main Methods:

  • Developed a serologic assay to detect S. maltophilia antibodies.
  • Conducted a cross-sectional study to correlate culture results with immune response.
  • Performed a retrospective cohort study using the Toronto CF Database (1997-2008) to assess disease severity.

Main Results:

  • Patients with chronic S. maltophilia showed significantly higher antibody levels to flagellin and whole cells.
  • Chronic infection was associated with a 1.63-fold increased risk of pulmonary exacerbations requiring hospitalization.
  • The cohort study included 692 CF patients with an average follow-up of 8.3 years.

Conclusions:

  • Chronic S. maltophilia infection in CF patients elicits a specific immune response.
  • Chronic S. maltophilia is an independent risk factor for pulmonary exacerbations in CF patients.

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