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1 Adult Cystic Fibrosis Unit, The Prince Charles Hospital, 2 Clinical Virology Research Unit, Sir Albert Sakzewski Virology Research Centre, 3 Dept of Respiratory Medicine, Royal Children's Hospital, 4 Paediatric and Child Health, 6 Dept of Medicine, University of Queensland and 5 Queensland Health Pathology Service, Queensland Health, Brisbane, Australia
CORRESPONDENCE: S.C. Bell, Thoracic Physician, Dept of Thoracic Medicine, The Prince Charles Hospital, Rode Road, Chermside 4032, Australia. Fax: 61 732125630. E-mail: scott_bell@health.qld.gov.au
Keywords: Clonal strain, cystic fibrosis, Pseudomonas aeruginosa, pulsed-field gel electrophoresis
Received: November 2, 2003
Accepted February 13, 2004
This study was supported by the Royal Children's Hospital Foundation Seeding grant R912-007, which was sponsored by the Cressbrook Committee.
Despite recent reports of clonal strains of Pseudomonas aeruginosa in cystic fibrosis (CF) units, the need for routine microbiological surveillance remains contentious.
Sputum was collected prospectively from productive patients attending the regional paediatric and adult CF units in Brisbane, Australia. All P. aeruginosa isolates were typed using pulsed-field gel electrophoresis. Spirometry, anthropometrics, hospitalisations and antibiotic sensitivity data were recorded.
The first 100 sputum samples (first 50 patients at each clinic) harboured 163 isolates of P. aeruginosa. A total of 39 patients shared a common strain (pulsotype 2), 20 patients shared a strain with at least one other patient and 41 patients harboured unique strains. Eight patients shared a strain identical to a previously reported Australian transmissible strain (pulsotype 1). Compared with the unique strain group, patients harbouring pulsotype 2 were younger and had poorer lung function. Treatment requirements were similar in these two groups, as were the rates of multiresistance.
In conclusion, 59% of patients harboured a clonal strain, supporting the need for routine microbiological surveillance. In contrast to previously described clonal strains, the dominant pulsotype was indistinguishable from nonclonal strains with respect to both colonial morphology and multiresistance. The clinical significance of clonal strains remains uncertain and requires longitudinal study.
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