Transmissibility of Pseudomonas cepacia Infection in Clinic Patients and Lung-Transplant Recipients with Cystic Fibrosis
| Autor: | Richard Goldstein, Peter H. Gilligan, Ru Zhang Jiang, Suzanne Steinbach, Thomas M. Egan, Patrick A. Flume, Li Sun |
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| Rok vydání: | 1994 |
| Předmět: |
DNA
Bacterial Lung Diseases congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Pancreatic disease Cystic Fibrosis medicine.medical_treatment Burkholderia cepacia DNA Ribosomal Cystic fibrosis Ribotyping Internal medicine Humans Medicine Lung transplantation Pseudomonas Infections rRNA Operon Lung business.industry Respiratory disease General Medicine medicine.disease Bacterial Typing Techniques Electrophoresis Gel Pulsed-Field respiratory tract diseases Transplantation medicine.anatomical_structure Immunology RRNA Operon business Polymorphism Restriction Fragment Length Lung Transplantation |
| Zdroj: | New England Journal of Medicine. 331:981-987 |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/nejm199410133311504 |
| Popis: | In patients with cystic fibrosis, infection with Pseudomonas cepacia is associated with poor outcomes. However, the extent of person-to-person transmission and the source of P. cepacia infection after lung transplantation are not well defined. Using DNA-based typing systems, we sought to determine the genetic relatedness of P. cepacia infection at one cystic fibrosis center.We analyzed 65 P. cepacia isolates gathered over a period of eight years at a single cystic fibrosis center from 17 clinic patients and from 5 patients who underwent double-lung transplantation. The isolates were analyzed by ribotyping and chromosomal fingerprinting based on pulsed-field gel electrophoresis.Analyses of serial isolates revealed that each clinic patient and transplant recipient harbored a different P. cepacia clone that was persistent. In the transplant recipients, the preoperative and postoperative isolates were identical. In the two patients with disseminated infection after lung transplantation, isolates from multiple sites were identical and indicated clonal expansion of the previous respiratory P. cepacia strain. Pulsed-field gel electrophoresis proved both more discriminative and more practical than ribotyping as a means of defining the genetic relatedness of the P. cepacia isolates.Our serial analyses in patients with cystic fibrosis at one center found distinct strains of P. cepacia persistently infecting each patient and no evidence of person-to-person transmission of this organism. P. cepacia infection after lung transplantation was due to the persistence of the strain present before transplantation. |
| Databáze: | OpenAIRE |
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