Changing Epidemiology ofPseudomonas aeruginosa Infection in Danish Cystic Fibrosis Patients (1974-1995)

作者：Birgitte Frederiksen, Christian Koch, Niels H�iby · 发表于：Pediatric Pulmonology · 年份：1999 · DOI：10.1002/(sici)1099-0496(199909)28:3<159::aid-ppul1>3.0.co;2-1 · 被引用次数：186 · 研究领域：Cystic Fibrosis Research Advances、Pneumonia and Respiratory Infections、Plant Pathogenic Bacteria Studies

Recurrent and chronic lower airway infection with Pseudomonas aeruginosa (PA) is an important component of cystic fibrosis (CF) pulmonary disease. Different modes of treatment and control of CF patients have been introduced at the Copenhagen CF Centre over the past 20 years and have been associated with improved survival. Treatment consisted of: 1) elective antibiotics for 14 days every 3 months to patients with chronic PA infection (started in 1976), 2) cohort isolation to prevent cross-infection (patients with PA were separated from patients without PA, starting in 1981); and 3) early intensive treatment with inhaled colistin and oral ciprofloxacin from time of initial PA colonization (started in 1989). The aim of the present study was to evaluate the impact of each of these interventions on the changes in the epidemiology of PA. Based on monthly cultures of lower airway secretions in each CF patient seen during 1974-1995, significant changes in the incidence and prevalence of the PA infection were found. The monthly prevalence of chronic PA increased significantly (P < 0.0001) from below 40% before 1976 to above 60% in 1980, which was found to be due to cross-infection among the CF patients after introduction of elective antibiotic courses in 1976. To deal with this problem, cohort isolation was introduced in 1981, and since then the monthly point prevalence of chronic PA decreased slowly until 1989 (P < 0.0001), when early intensive treatment from initial PA colonization ...