Antimicrobial activity of tobramycin against Pseudomonas aeruginosa strains isolated from patients with cystic fibrosis
Abstract
In patients with cystic flbrosis, lower respiratory tract infections are characterized by a steadily recurrent and severe course. Recently, inhaled tobramycin has been successfully used to treat Pseudomonas aeruginosa-iniucei diseases in children aged over 6 years. In this trial, the E-test (Liofilchem, Italy) was employed to determine the antimicrobial activity of tobramycin against 40 P. aeruginosa strains isolated from 25 patients with cystic fibrosis in the period 2005—2009. At the same time MIC50 and MIC90 were 0,75 and 3,0 mg/ml, respectively. No relationship to patient age (and duration of P. aeruginosa colonization) was established. Tobramycin showed high activity in vitro against P. aeruginosa strains isolated from the patients with cystic flbrosis. The activity was related to the morphology of a strain and previous treatment with inhaled tobramycin. When initiating its inhalation treatment in cases of inoculation of moderately susceptible or resistant P. aeruginosa strains (according to the CLSI criteria), it is necessary to interpret their susceptibility test results by following the MENSURA Group criteria.
About the Authors
P. PerenovskaBulgaria
G. Stoyanova
Bulgaria
T. Strateva
Bulgaria
References
1. Стратева Т. Pseudomonas aeruginosa — феномен на бак-териална резистентност. Съвременна медицина 2007; 2: 25-40.
2. Ratjen F., Boring G. Cystic fibrosis (seminar). Lancet 2003; 361:681-689.
3. Henry R.L., Mellis СМ., Petrovic L. Mucoid Pseudomonas aeruginosa is a marker of poor survival in cystic fibrosis. Pediat Pulmonol 1992; 12: 158-161.
4. Ramsey B.W., Pepe M.S., Quan J.M. et al. Intermittent administration of inhaled tobramycin in patients with cystic fibrosis. N Engl J Med 1999; 340: 23-30.
5. Canton R., Cobos N., de Gracia J. et al. Antimicrobial therapy for pulmonary pathogenic colonization and infection by Pseudomonas aeruginosa in cystic fibrosis patients. Clin Microbiol Infect 2005; 11:9:690-703.
6. CLSI (2007). Performance standards for antimicrobial susceptibility testing; 17th informational supplement. CLSI M100-S17. Clinical and Laboratory Standards Institute, Wayne P. A. www.microbiolab-bg.com>CLSI.pdf
7. Morosini M.I., Garcia-Castillo M., Loz,a E. et al. Breakpoints for predicting Pseudomonas aeruginosa susceptibility to inhaled tobramycin in cystic fibrosis patients: use of high-range Etest strips. J Clin Microbiol 2005; 43: 9: 4480-4485.
8. Cystic Fibrosis Foundation. 1994. Microbiology and infectious disease in cystic fibrosis. Consensus Conference: Concepts in Care. Vol. 5, section 1. Bethesda, MD: Cystic Fibrosis Foundation, www.cysticfibrosis.org.uk/
9. Geller D.E., Pitlick W.H., Nardella PA. et al. Pharmacokine-tics and bioavailability of aerosolized tobramycin in cystic fibrosis. Chest 2002; 122: 219-226.
10. Pitt T.L., Sparrow M., Stefanidou M. Survey of resistance of Pseudomonas aeruginosa from UK patients with cystic fibrosis to six commonly prescribed antimicrobial agents.
11. Thorax 2003; 58: 9: 794-796.
12. Govan J.R., Deretic V. Microbial pathogenesis in cystic fibrosis: mucoid Pseudomonas aeruginosa and Burkholderia cepa-cia. Microbiol Rev 1996; 60: 3: 539-574.
13. Mah T.F., Pitts В., Pellock B. et al. A genetic basis for Pseudomonas aeruginosa biofilm antimicrobial resistance. Nature 2003; 426: 6964: 306-310.
14. Zhang L., Mah T.F. Involvement of a novel efflux system inbiofilm-specific resistance to antibiotics. J Bacteriol 2008; 190: 13: 4447-4452.
15. Ciofu O., Fussing V., Bagge N. et al. Characterization of pared mucoid/non-mucoid Pseudomonas aeruginosa isolates from Danish cystic fibrosis patients: antibiotic resistance, |3-lactamase activity and ribotyping. J Antimicrob Chemother 2001; 48: 3:391-396.
16. Shawar R.M., MacLeod D.L., Garber R.L. et al. Activities of tobramycin and six other antibiotics against Pseudomonas aeruginosa isolates from patients with cystic fibrosis. Antimicrob Agents Chemother 1999; 43: 12: 2877-2880.
17. Schulin T. In vitro activity of the aerosolized agents colistin and tobramycin and five intravenous agents against Pseudomonas aeruginosa isolated from cystic fibrosis patients in southwestern Germany. J Antimicrob Chemother 2002; 49: 2: 403-406.
18. Burns J.L., Van Dalfsen J.M., Shawar R.M. et al. Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis. J Infect Dis 1999; 179: 5:1190-1196.
19. Hoffman L.R., D'Argenio D.A., MacCoss M.J. et al. Aminoglycoside antibiotics induce bacterial biofilm formation. Nature 2005; 436: 7054: 1171-1175.
Review
For citations:
Perenovska P., Stoyanova G., Strateva T. Antimicrobial activity of tobramycin against Pseudomonas aeruginosa strains isolated from patients with cystic fibrosis. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2015;60(1):89-92. (In Russ.)