Early treatment with inhaled antibiotics postpones next occurrence of Achromobacter in cystic fibrosis |
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Authors: | M. Wang W. Ridderberg C.R. Hansen N. Høiby S. Jensen-Fangel H.V. Olesen M. Skov L.E. Lemming T. Pressler H.K. Johansen N. Nørskov-Lauritsen |
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Affiliation: | 1. Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark;2. Copenhagen CF centre, Department of Paediatrics and Department of Infectious Diseases, Denmark;3. Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Denmark;4. Department of Infectious Diseases, Aaehus University Hospital, Aarhus, Denmark;5. Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark |
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Abstract: | ObjectivesIn this nationwide retrospective study, we analysed species distribution, antimicrobial susceptibility and time to next occurrence of Achromobacter in Danish cystic fibrosis (CF) patients from 2000 to 2011.MethodsThirty-four primary isolates were identified to species level and subjected to antimicrobial susceptibility testing. Effectiveness of early antimicrobial treatment was assessed by a Kaplan–Meier estimation of time to recurrence.ResultsAchromobacter xylosoxidans accounted for 13 (38%) of the isolates, and an unnamed species accounted for 11 (32%) of the isolates. Meropenem, piperacillin–tazobactam and trimethoprim–sulfamethoxazole were highly active against chemotherapy-naïve Achromobacter, while ceftazidime, colistin and tobramycin were judged adequate for inhalation therapy. Fifty-five percent of 25 patients treated with inhaled ceftazidime, colistin, or tobramycin remained free of Achromobacter three years after acquisition, in contrast to 17% of 22 patients who did not receive inhaled antibiotics (P < 0.01).ConclusionsEarly treatment with inhaled antibiotics may prevent or postpone chronic infection with Achromobacter in CF patients. |
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