BACKGROUND: Bacteria grow as biofilms within CF airways. However, antibiotic susceptibility testing is routinely performed on planktonically-growing bacteria. This study assessed whether CF patients infected with multiresistant organisms had improved clinical outcomes if given antibiotics that inhibited their biofilm-grown bacteria. METHODS: 110 patients with pulmonary exacerbations were treated with intravenous antibiotics based on susceptibility testing of planktonically-growing bacteria. A retrospective analysis was done using bacterial isolates grown from their sputum at exacerbation. Each isolate was grown as a biofilm and combination antibiotic susceptibility testing was performed. Clinical outcomes in patients treated with biofilm-susceptible antibiotics were compared to those that were not. RESULTS: 66 of 110 patients (60%) were treated with antibiotic combinations that inhibited all of their planktonically-grown bacterial isolates, however, when the same isolates were grown as biofilms, only 24 patients (22%) had all of their biofilm-grown isolates remaining susceptible to the antibiotics (P=<0.001 ). When patients with at least one biofilm-grown susceptible isolate (n=61) were compared to those with none (n=49), there was a significant decrease in sputum bacterial density (P=0.02) and length of stay (P=0.04) and a non-significant decrease in treatment failure. Survival analyses of time to next exacerbation showed non-significant trends favoring patients treated with biofilm-effective antibiotics. CONCLUSIONS: Most patients with CF exacerbations do not receive antibiotics that inhibit all biofilm-grown bacteria from their sputum at exacerbation. Patients treated with biofilm-effective therapy seemed to have improved clinical outcomes.
BACKGROUND: Bacteria grow as biofilms within CF airways. However, antibiotic susceptibility testing is routinely performed on planktonically-growing bacteria. This study assessed whether CF patients infected with multiresistant organisms had improved clinical outcomes if given antibiotics that inhibited their biofilm-grown bacteria. METHODS: 110 patients with pulmonary exacerbations were treated with intravenous antibiotics based on susceptibility testing of planktonically-growing bacteria. A retrospective analysis was done using bacterial isolates grown from their sputum at exacerbation. Each isolate was grown as a biofilm and combination antibiotic susceptibility testing was performed. Clinical outcomes in patients treated with biofilm-susceptible antibiotics were compared to those that were not. RESULTS: 66 of 110 patients (60%) were treated with antibiotic combinations that inhibited all of their planktonically-grown bacterial isolates, however, when the same isolates were grown as biofilms, only 24 patients (22%) had all of their biofilm-grown isolates remaining susceptible to the antibiotics (P=<0.001 ). When patients with at least one biofilm-grown susceptible isolate (n=61) were compared to those with none (n=49), there was a significant decrease in sputum bacterial density (P=0.02) and length of stay (P=0.04) and a non-significant decrease in treatment failure. Survival analyses of time to next exacerbation showed non-significant trends favoring patients treated with biofilm-effective antibiotics. CONCLUSIONS: Most patients with CF exacerbations do not receive antibiotics that inhibit all biofilm-grown bacteria from their sputum at exacerbation. Patients treated with biofilm-effective therapy seemed to have improved clinical outcomes.
Authors: Samuel M Moskowitz; Julia C Emerson; Sharon McNamara; Richard D Shell; David M Orenstein; Daniel Rosenbluth; Marcia F Katz; Richard Ahrens; Douglas Hornick; Patricia M Joseph; Ronald L Gibson; Moira L Aitken; Wade W Benton; Jane L Burns Journal: Pediatr Pulmonol Date: 2010-10-20
Authors: J Fricks-Lima; C M Hendrickson; M Allgaier; H Zhuo; J P Wiener-Kronish; S V Lynch; K Yang Journal: Int J Antimicrob Agents Date: 2011-03-05 Impact factor: 5.283
Authors: Luca Freschi; Julie Jeukens; Irena Kukavica-Ibrulj; Brian Boyle; Marie-Josée Dupont; Jérôme Laroche; Stéphane Larose; Halim Maaroufi; Joanne L Fothergill; Matthew Moore; Geoffrey L Winsor; Shawn D Aaron; Jean Barbeau; Scott C Bell; Jane L Burns; Miguel Camara; André Cantin; Steve J Charette; Ken Dewar; Éric Déziel; Keith Grimwood; Robert E W Hancock; Joe J Harrison; Stephan Heeb; Lars Jelsbak; Baofeng Jia; Dervla T Kenna; Timothy J Kidd; Jens Klockgether; Joseph S Lam; Iain L Lamont; Shawn Lewenza; Nick Loman; François Malouin; Jim Manos; Andrew G McArthur; Josie McKeown; Julie Milot; Hardeep Naghra; Dao Nguyen; Sheldon K Pereira; Gabriel G Perron; Jean-Paul Pirnay; Paul B Rainey; Simon Rousseau; Pedro M Santos; Anne Stephenson; Véronique Taylor; Jane F Turton; Nicholas Waglechner; Paul Williams; Sandra W Thrane; Gerard D Wright; Fiona S L Brinkman; Nicholas P Tucker; Burkhard Tümmler; Craig Winstanley; Roger C Levesque Journal: Front Microbiol Date: 2015-09-29 Impact factor: 5.640
Authors: Rounak Feigelman; Christian R Kahlert; Florent Baty; Frank Rassouli; Rebekka L Kleiner; Philipp Kohler; Martin H Brutsche; Christian von Mering Journal: Microbiome Date: 2017-02-10 Impact factor: 14.650