ChronicPseudomonas aeruginosaInfection in Chronic Obstructive Pulmonary Disease
Open Access
- 15 December 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 47 (12), 1526-1533
- https://doi.org/10.1086/593186
Abstract
Background.Pseudomonas aeruginosa infections are increasingly associated with acute exacerbations in chronic obstructive pulmonary disease (COPD). We aimed to determine whether an underlying chronic infection might be behind this process and to determine the epidemiological characteristics of the isolates involved, to implement useful protocols for preventing and treating these infections. Methods. P. aeruginosa isolates obtained from respiratory samples of 13 patients with COPD and from blood samples of 10 patients in intensive care units were investigated. In 8 patients with COPD, isolates were obtained during sequential exacerbation episodes. Five patients presented a single infection episode. Production of virulence determinants and genetic relationships were analyzed in all isolates. Results. Patients with COPD were usually infected with 1 P. aeruginosa clone that remained in the lung for years, without evidence of interpatient transmission. During chronic infection, each clone diversified, which led to the coexistence of isolates with different morphotypes and antibiotic susceptibility. Overall, P. aeruginosa evolved toward an increased mutation rate, increased antibiotic resistance, and reduced production of proteases. Isolates from samples of infected lungs tend to be less cytotoxic and motile and to produce more biofilm, compared with isolates from blood samples. Conclusion. These results provide the first evidence supporting the hypothesis that P. aeruginosa causes chronic infections in COPD, with patterns of infection and evolution that resemble those observed in cystic fibrosis. Experience gained from treating cystic fibrosis might be useful for implementing new procedures for the prevention, diagnosis, and treatment of infection due to P. aeruginosa in COPD.Keywords
This publication has 38 references indexed in Scilit:
- Swarming ofPseudomonas aeruginosaIs a Complex Adaptation Leading to Increased Production of Virulence Factors and Antibiotic ResistanceJournal of Bacteriology, 2008
- Experimental validation of Haldane's hypothesis on the role of infection as an evolutionary force for MetazoansProceedings of the National Academy of Sciences of the United States of America, 2007
- Phenotypic Characterization of Clonal and Nonclonal Pseudomonas aeruginosa Strains Isolated from Lungs of Adults with Cystic FibrosisJournal of Clinical Microbiology, 2007
- Molecular Epidemiology and Dynamics of Pseudomonas aeruginosa Populations in Lungs of Cystic Fibrosis PatientsInfection and Immunity, 2007
- Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic reviewRespiratory Research, 2007
- Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesisThorax, 2007
- Antibiotics as intermicrobial signaling agents instead of weaponsProceedings of the National Academy of Sciences of the United States of America, 2006
- Sputum bacteriology in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in Taiwan with an emphasis on Klebsiella pneumoniae and Pseudomonas aeruginosaRespirology, 2006
- Antimicrobial therapy for pulmonary pathogenic colonisation and infection by Pseudomonas aeruginosa in cystic fibrosis patientsClinical Microbiology & Infection, 2005
- Inhaled Tobramycin (TOBI??)Drugs, 2003