Molecular epidemiology of chronic Pseudomonas aeruginosa airway infections in cystic fibrosis

TY - JOUR

T1 - Molecular epidemiology of chronic Pseudomonas aeruginosa airway infections in cystic fibrosis

AU - Cramer, Nina

AU - Wiehlmann, Lutz

AU - Ciofu, Oana

AU - Tamm, Stephanie

AU - Høiby, Niels

AU - Tümmler, Burkhard

PY - 2012/11/28

Y1 - 2012/11/28

N2 - Background/Methods: The molecular epidemiology of the chronic airway infections with Pseudomonas aeruginosa in individuals with cystic fibrosis (CF) was investigated by cross-sectional analysis of bacterial isolates from 51 CF centers and by longitudinal analysis of serial isolates which had been collected at the CF centers Hanover and Copenhagen since the onset of airway colonization over 30 years. Results: Genotyping revealed that the P. aeruginosa population in CF is dominated by a few ubiquitous clones. The five most common clones retrieved from the CF host also belonged to the twenty most frequent clones in the environment and in other human disease habitats. Turnover of clones in CF airways was rare. At the Hanover clinic more than half of the patient cohort was still harbouring the initially acquired clone after twenty years of airway colonization. At the Copenhagen clinic, however, two rare clones replaced the initially acquired individual clones in all but one patient. Conclusion: The divergent epidemiology at the two sites is explained by their differential management of hygiene and antipseudomonal chemotherapy. Hygienic measures to prohibit patient-to-patient transmission and the modalities of antipseudomonal chemotherapy modify the epidemiology of the chronic P. aeruginosa infections in CF.

AB - Background/Methods: The molecular epidemiology of the chronic airway infections with Pseudomonas aeruginosa in individuals with cystic fibrosis (CF) was investigated by cross-sectional analysis of bacterial isolates from 51 CF centers and by longitudinal analysis of serial isolates which had been collected at the CF centers Hanover and Copenhagen since the onset of airway colonization over 30 years. Results: Genotyping revealed that the P. aeruginosa population in CF is dominated by a few ubiquitous clones. The five most common clones retrieved from the CF host also belonged to the twenty most frequent clones in the environment and in other human disease habitats. Turnover of clones in CF airways was rare. At the Hanover clinic more than half of the patient cohort was still harbouring the initially acquired clone after twenty years of airway colonization. At the Copenhagen clinic, however, two rare clones replaced the initially acquired individual clones in all but one patient. Conclusion: The divergent epidemiology at the two sites is explained by their differential management of hygiene and antipseudomonal chemotherapy. Hygienic measures to prohibit patient-to-patient transmission and the modalities of antipseudomonal chemotherapy modify the epidemiology of the chronic P. aeruginosa infections in CF.

KW - Cross-Sectional Studies

KW - Cystic Fibrosis

KW - Female

KW - Genotype

KW - Humans

KW - Male

KW - Molecular Epidemiology

KW - Pseudomonas Infections

KW - Pseudomonas aeruginosa

U2 - 10.1371/journal.pone.0050731

DO - 10.1371/journal.pone.0050731

M3 - Journal article

C2 - 23209821

SN - 1932-6203

VL - 7

JO - PLoS Computational Biology

JF - PLoS Computational Biology

IS - 11

M1 - e50731

ER -