The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients.
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.The effect of strict segregation on the incidence of P. aerug...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2016-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4900627?pdf=render |
| _version_ | 1818038196621017088 |
|---|---|
| author | Rosa van Mansfeld Angelica de Vrankrijker Roland Brimicombe Harry Heijerman Ferdinand Teding van Berkhout Cristian Spitoni Sanne Grave Cornelis van der Ent Tom Wolfs Rob Willems Marc Bonten |
| author_facet | Rosa van Mansfeld Angelica de Vrankrijker Roland Brimicombe Harry Heijerman Ferdinand Teding van Berkhout Cristian Spitoni Sanne Grave Cornelis van der Ent Tom Wolfs Rob Willems Marc Bonten |
| author_sort | Rosa van Mansfeld |
| collection | DOAJ |
| description | 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.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).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.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. |
| first_indexed | 2024-12-10T07:38:54Z |
| format | Article |
| id | doaj.art-75db28a6a59c4525b8fd5c4eb9c058eb |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T07:38:54Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-75db28a6a59c4525b8fd5c4eb9c058eb2022-12-22T01:57:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01116e015718910.1371/journal.pone.0157189The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients.Rosa van MansfeldAngelica de VrankrijkerRoland BrimicombeHarry HeijermanFerdinand Teding van BerkhoutCristian SpitoniSanne GraveCornelis van der EntTom WolfsRob WillemsMarc BontenSegregation 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.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).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.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.http://europepmc.org/articles/PMC4900627?pdf=render |
| spellingShingle | Rosa van Mansfeld Angelica de Vrankrijker Roland Brimicombe Harry Heijerman Ferdinand Teding van Berkhout Cristian Spitoni Sanne Grave Cornelis van der Ent Tom Wolfs Rob Willems Marc Bonten The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients. PLoS ONE |
| title | The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients. |
| title_full | The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients. |
| title_fullStr | The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients. |
| title_full_unstemmed | The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients. |
| title_short | The Effect of Strict Segregation on Pseudomonas aeruginosa in Cystic Fibrosis Patients. |
| title_sort | effect of strict segregation on pseudomonas aeruginosa in cystic fibrosis patients |
| url | http://europepmc.org/articles/PMC4900627?pdf=render |
| work_keys_str_mv | AT rosavanmansfeld theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT angelicadevrankrijker theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT rolandbrimicombe theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT harryheijerman theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT ferdinandtedingvanberkhout theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT cristianspitoni theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT sannegrave theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT cornelisvanderent theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT tomwolfs theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT robwillems theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT marcbonten theeffectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT rosavanmansfeld effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT angelicadevrankrijker effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT rolandbrimicombe effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT harryheijerman effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT ferdinandtedingvanberkhout effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT cristianspitoni effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT sannegrave effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT cornelisvanderent effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT tomwolfs effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT robwillems effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients AT marcbonten effectofstrictsegregationonpseudomonasaeruginosaincysticfibrosispatients |