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Is the improvement of CF patients, hospitalized for pulmonary exacerbation, correlated to a decrease in bacterial

Pieter Deschaght1, Petra Schelstraete, Leen Van Simaey

  • 1Laboratory Bacteriology Research (LBR), Faculty of Medicine & Health Sciences, Universiteit Gent, Ghent, Belgium.

Plos One
|December 7, 2013
PubMed
Abstract

Insights

Cystic Fibrosis patients clinically improve with antibiotic treatment, showing reduced Pseudomonas aeruginosa and total bacterial load within the first week. However, this bacterial reduction is not observed in patients with low lung function.

Area of Science:

  • Medical Microbiology
  • Pulmonology
  • Infectious Diseases

Background:

  • Cystic Fibrosis (CF) patients are susceptible to Pseudomonas aeruginosa airway colonization.
  • Chronic P. aeruginosa colonization leads to recurrent pulmonary exacerbations requiring hospitalization and intravenous antibiotics.
  • Standard antibiotic treatment typically results in patient health improvement.

Purpose of the Study:

  • To determine the correlation between clinical improvement in CF patients and changes in P. aeruginosa and total bacterial load in sputum.
  • To investigate the impact of lung function on bacterial load reduction during treatment.

Main Methods:

  • Studied 18 CF patients during 27 hospitalization episodes for exacerbations.
  • Assessed inflammation and lung function parameters (FEV1) on days 1, 8, and 15.
  • Quantified P. aeruginosa load using culture, quantitative PCR (qPCR), and propidium monoazide qPCR.

Main Results:

  • Patients showed significant clinical improvement within one week, with normalized inflammation markers and increased FEV1.
  • Both P. aeruginosa and total bacterial loads decreased significantly (p<0.05) in the first week of treatment.
  • Patients with low lung function (FEV1≤39.4%) did not exhibit a significant decrease in P. aeruginosa load.
  • Propidium monoazide qPCR revealed that 62% of P. aeruginosa cells were non-cultivable, suggesting dormancy or structural integrity despite non-viability.

Conclusions:

  • Clinical improvement in CF patients correlates with a reduction in P. aeruginosa load, primarily during the first week of antibiotic therapy.
  • The reduction in P. aeruginosa load is not observed in patients with compromised lung function.
  • A significant proportion of P. aeruginosa detected by qPCR are non-cultivable, indicating the presence of dormant or dead but intact cells.

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