Related Experiment Videos
The epidemiology of Pseudomonas cepacia in patients with cystic fibrosis
O C Tablan1, W J Martone, W R Jarvis
1Epidemiology Branch, Centers for Disease Control, Atlanta, Georgia 30333.
Insights
Pseudomonas cepacia is a growing threat in cystic fibrosis (CF) care, causing worse outcomes. Early detection and infection control are crucial for managing this nosocomial pathogen in CF patients.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pulmonology
Background:
- Pseudomonas cepacia is an emerging nosocomial pathogen.
- It colonizes and infects the respiratory tract of cystic fibrosis (CF) patients.
- Colonization is associated with adverse outcomes in CF patients.
Purpose of the Study:
- To highlight the increasing incidence and prevalence of P. cepacia in the US.
- To discuss challenges in assessing P. cepacia outcomes and transmission.
- To recommend prudent measures for CF centers.
Main Methods:
- Review of controlled studies on P. cepacia outcomes.
- Analysis of national trends in P. cepacia incidence and prevalence.
- Discussion of laboratory detection methods and transmission routes.
Main Results:
- P. cepacia colonization is linked to poorer outcomes in CF patients.
- An increasing trend in P. cepacia colonization exists in the US.
- Estimates may be biased by varying detection methods between centers.
Conclusions:
- The source and transmission of P. cepacia remain unclear.
- CF centers should consider selective media for P. cepacia isolation.
- Infection control precautions for resistant gram-negative organisms are advised.
Abstract:
Pseudomonas cepacia has emerged as an important nosocomial pathogen colonizing and infecting the respiratory tract of patients with cystic fibrosis (CF). Although assessment of outcomes associated with P. cepacia colonization has been difficult, controlled studies have shown that colonized patients experience more adverse outcomes compared with those not colonized. In the United States, an increasing trend in national incidence and prevalence of P. cepacia colonization has been shown, but cases have been unevenly distributed in a few centers. These estimates, however, may be biased by intercenter differences in laboratory methods for detecting P. cepacia in patient sputum. The source and mode of transmission of P. cepacia have not been adequately demonstrated, and may vary from center to center. Until further studies elucidate the epidemiology of P. cepacia in patients with CF, it may be prudent for CF centers to consider the use of selective media to isolate P. cepacia from sputa of patients with CF, to conduct investigations of clusters of P. cepacia-colonized patients, and to consider adopting infection control precautions recommended for control of multiply resistant gram negative organisms.