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Pseudomonas
- Question
- What are the consequences?
- Answer
- Dear questioner,
Thank you for your question.
Not only patients with cystic fibrosis but also children with an immune deficiency are more vulnerable to infection with the bacteria Pseudomonas aeruginosa. In the case of patients with cystic fibrosis it is unclear why they are so vulnerable. It is equally not understood why some patients get infected with this bacteria early on and in other cases it occurs only later. We do know that infection with Pseudomonas is typical for the disease cystic fibrosis and that nearly every child or adult will sooner or later become colonised with Pseudomonas. Yearly about 20% of patients will contract a new Pseudomonas infection and the chance of chronic infection increases with age. About 70 to 80% of adults with CF patients are chronically infected with P.aeruginosa. In long term survivors (past age 50 years) this percentage is lower.
Usually the Pseudomonas bacteria is contracted from the environment. Pseudomonas is abundantly present in the environment, especially in warm and stagnant waters, but it also grows on fruits and vegetables (e.g. tomatoes). Contact with Pseudomonas can therefore not be avoided. Infection with Pseudomonas can also occur from acquiring the bacteria from other patients with cystic fibrosis, although this is not a frequent event provided that specific hygienic measures are taken in all CF centres to avoid contact between patients with and without chronic Pseudomonas. Strict hand hygiene in the hospital and also outside of the hospital has proven beneficial.
In case of first infection or early infection or new infection after a period without Pseudomonas infection, there is consensus that treatment should be started in an effort to eradicate the bacteria. Several treatment schedules are used an it is unclear which is best.
Many studies have demonstrated that chronic infection with Pseudomonas can lead to a faster deterioration of lung function and is associated with a higher need of therapy. Usually a maintenance treatment with antibiotics will be instituted for instance tobramycin or colimycin. This will not eradicate the bacteria but will combat the progression of lung disease.
We hope that this answer helps you.
Prof. Kris de Boeck - 03.05.2012
