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The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients
- Source :
- PLoS ONE, Vol 11, Iss 6, p e0157189 (2016), PLoS One, 11(6), 1. Public Library of Science, PLoS ONE
- Publication Year :
- 2016
- Publisher :
- Public Library of Science (PLoS), 2016.
-
Abstract
- INTRODUCTION: Segregation of patients with cystic fibrosis (CF) was implemented to prevent chronic infection with epidemic Pseudomonas aeruginosa strains with presumed detrimental clinical effects, but its effectiveness has not been carefully evaluated. METHODS: The effect of strict segregation on the incidence of P. aeruginosa infection in CF patients was investigated through longitudinal protocolized follow-up of respiratory tract infection before and after segregation. In two nested cross-sectional studies in 2007 and 2011 the P. aeruginosa population structure was investigated and clinical parameters were determined in patients with and without infection with the Dutch epidemic P. aeruginosa clone (ST406). RESULTS: Of 784 included patients 315 and 382 were at risk for acquiring chronic P. aeruginosa infection before and after segregation. Acquisition rates were, respectively, 0.14 and 0.05 per 1,000 days at risk (HR: 0.66, 95% CI [0.2548-1.541]; p = 0.28). An exploratory subgroup analysis indicated lower acquisition after segregation in children < 15 years of age (HR: 0.43, 95% CI[0.21-0.95]; p = 0.04). P. aeruginosa population structure did not change after segregation and ST406 was not associated with lung function decline, death or lung transplantation. CONCLUSIONS: Strict segregation was not associated with a statistically significant lower acquisition of chronic P. aeruginosa infection and ST406 was not associated with adverse clinical outcome. After segregation there were no new acquisitions of ST406. In an unplanned exploratory analysis chronic acquisition of P. aeruginosa was lower after implementation of segregation in patients under 15 years of age.
- Subjects :
- 0301 basic medicine
Male
Bacterial Diseases
Cystic Fibrosis
medicine.medical_treatment
Prevalence
lcsh:Medicine
medicine.disease_cause
Pathology and Laboratory Medicine
Cystic fibrosis
Pulmonary function testing
Patient Isolation
Geographical Locations
0302 clinical medicine
Antibiotics
Medicine and Health Sciences
Ethnicities
Respiratory System Procedures
Child
lcsh:Science
Netherlands
Multidisciplinary
Antimicrobials
Incidence (epidemiology)
Pseudomonas Aeruginosa
Drugs
Bacterial Pathogens
Europe
Infectious Diseases
Medical Microbiology
Research Design
Child, Preschool
Female
Pathogens
Research Article
Lung Transplantation
Adult
medicine.medical_specialty
Adolescent
Surgical and Invasive Medical Procedures
Biology
Research and Analysis Methods
Microbiology
03 medical and health sciences
Internal medicine
Pseudomonas
Microbial Control
medicine
Lung transplantation
Humans
Pseudomonas Infections
Molecular Biology Techniques
Microbial Pathogens
Molecular Biology
Dutch People
Pharmacology
Transplantation
Bacteria
Pseudomonas aeruginosa
lcsh:R
Organisms
Biology and Life Sciences
Organ Transplantation
medicine.disease
Chronic infection
030104 developmental biology
Cross-Sectional Studies
030228 respiratory system
Chronic Disease
People and Places
Population Groupings
lcsh:Q
Cloning
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 11
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....e7e13b89e8e8b0902ef22b71d87aa8a3