Summary
A microbiological analysis of 102 patients suffering from cystic fibrosis was conducted over a 22 month period. 20 microbial species with the following incidence were identified:Pseudomonas aeruginosa: 83.4%;Candida albicans: 29.4%;Staphylococcus aureus: 24.5%;Staphylococcus epidermidis: 11.8%;Haemophilus influenzae: 11.8%;Streptococcus pneumoniae: 6.9%;Pseudomonas maltophilia: 6.8%;Aspergillus fumigatus: 5.9%. Other species were present in less than 5% of the patients. In the majority of specimens withP. aeruginosa, more than one type (up to six) was detectable. These strains were identical in colony appearance, O-serotype and pyocin-type. Quantitative analysis revealed concentrations of colony-forming units of 107 to 109 forP. aeruginosa, 106 to 108 forP. maltophilia, 104 to 107 forS. aureus, 104 to 106 forS. epidermidis and 104 to 107 forC. albicans in the majority of specimens. Significant differences were observed in the time periods during which the pathogens persisted in the patients. Maximum persistence was observed forP. aeruginosa. P. maltophilia andA. fumigatus had about similar persistence rates, which were lower than those forP. aeruginosa but above those forS. aureus andH. influenzae. S. epidermidis was eliminated within shorter periods thanS. aureus. C. albicans, although the second most frequent microorganism identified, showed a very low persistence rate. The microbiological analysis confirms results from other research centers (high incidence ofP. aeruginosa), but reveals significant regional differences as well (Pseudomonas cepacia not detectable, higher incidence ofP. maltophilia andC. albicans). This underlines the necessity for detailed qualitative and quantitative microbiological analysis of sputa from cystic fibrosis patients as a prerequisite for rational analysis of etiological, epidemiological and therapeutical aspects of cystic fibrosis.
Zusammenfassung
In Sputumproben von 102 Mukoviszidosepatienten konnten innerhalb von 22 Monaten insgesamt 20 verschiedene Mikroorganismenarten nachgewiesen werden. Ihr Auftreten verteilt sich wie folgt (in % der Patienten):Pseudomonas aeruginosa 83,4%,Candida albicans 29,4%,Staphylococcus aureus 24,5%,Staphylococcus epidermidis 11.8%,Haemophilus influenzae 11,8%,Streptococcus pneumoniae 6,9%,Pseudomonas maltophilia 6,8%,Aspergillus fumigatus 5,9%. Alle übrigen Spezies kamen in weniger als 5% der Patienten vor.Ps. aeruginosa trat überwiegend in mehreren Typen pro Patient auf (bis zu 6). Quantitative Unterschiede zwischen den Spezies wurden erkennbar: pro Gramm Sputum lagen die Koloniebildnerzahlen zwischen folgenden Grenzwerten:Ps. aeruginosa 107–109,Ps. maltophilia 106–108,S. aureus 104–107,S. epidermidis 104–106,Candida albicans 104–107. Der kontinuierliche Nachweis für einzelne Spezies und Typen im individuellen Patienten nahm in folgender Reihenfolge ab:Ps. aeruginosa, Ps. maltophilia, Aspergillus fumigatus, S. aureus, H. influenzae, S. epidermidis, Candida albicans. Diese Resultate deuten auf bemerkenswerte Unterschiede in der mikrobiologischen Konstellation verschiedener Zentren und Regionen bei Mukoviszidosepatienten hin und unterstreichen die Notwendigkeit für die Erhebung lokaler und individueller Daten als Grundlage für die Analytik von Ätiologie und Epidemiologie sowie rationale Chemotherapie bei Mukoviszidose.
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Bauernfeind, A., Hörl, G., Jungwirth, R. et al. Qualitative and quantitative microbiological analysis of sputa of 102 patients with cystic fibrosis. Infection 15, 270–277 (1987). https://doi.org/10.1007/BF01644137
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DOI: https://doi.org/10.1007/BF01644137