Imamovic, Lejla

Johansen, Helle Krogh

Molin, Søren

Pressler, Tacjana

Sommer, L.M.

Sommer, Morten Otto Alexander

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Downloaded from orbit.dtu.dk on: Dec 16, 2017Collateral sensitivity cycling of antibiotics for cystic fibrosis airwaySommer, L.M.; Imamovic, Lejla; Pressler, Tacjana; Sommer, Morten Otto Alexander; Molin, Søren;Johansen, Helle KroghPublished in:Journal of Cystic FibrosisLink to article, DOI:10.1016/S1569-1993(16)30365-4Publication date:2016Document VersionPublisher's PDF, also known as Version of recordLink back to DTU OrbitCitation (APA):Sommer, L. M., Imamovic, L., Pressler, T., Sommer, M. O. A., Molin, S., & Johansen, H. K. (2016). Collateralsensitivity cycling of antibiotics for cystic fibrosis airway. Journal of Cystic Fibrosis, 15(Suppl. 1), 583. [127]. DOI:10.1016/S1569-1993(16)30365-4Posters / Journal of Cystic Fibrosis 15 (2016) S51–S120 S83Methods: Epidemiological ambispective multicenter study. Healthstatus was measured by EQ-5D-3L questionnaire [Descriptive part (DS)(5 dimensions) + EQ-VAS]. PEx were deﬁned as the European ConsensusGroup proposal. Patients were included consecutively. Informed consentwas collected and the study was approved by the EC of the Ramon yCajal Hospital.The communication corresponds to an interim analysis.Results: Data from 145 patients were collected (49% from the theoreticalnumber). 54% were female. 66 patients were included without PEx, 47had mild PEx and 32 had severe PEx. 63, 47 and 35 patients had a mild,moderate or severe disease respectively. DS score in patients with severePEx were worse than patients with mild PEx (p-values from 0.039 to<0.001 among different dimensions), the same was seen with 5Q-VASscore (52.58±14.25 vs 70.98±18.22; p < 0.001). DS score by state of lungdisease was different between moderate and severe patients in two ofﬁve dimensions whereas 5Q-VAS score was not different (63.50±19.28vs 56.91±21.52; p=N.S.).Conclusion: Health status in patients with more severe status (eitherlung disease or PEx at inclusion) is worse than in the remainingpatients as expected. Patients suffering a severe PEx have health statusmeasurements (dimensions and VAS) lower than patients with a severelung status which seems to show the important role of PEx in patient’squality of life.126Lung function response to intravenous antibiotic treatment ina paediatric CF population in East of EnglandY.P. Delgado-Pen˜a1, L. Thanikkel1, P. Anjay1, C. Kavanagh1. 1Norfolk andNorwich University Hospital, Paediatrics Respiratory Medicine, Norwich,United KingdomObjectives: Our purpose was to characterize the Forced ExpiratoryVolume in 1 second (FEV1) and forced expiratory ﬂow rate between25% and 75% of vital capacity (FEF25–75) response to intravenousantibiotic therapy in our CF paediatric population between January2015 and December 2015.Methods: Data were obtained from a retrospective and descriptiveanalysis of IV treatment courses given during January to December2015 to CF children attending the Norfolk and Norwich UniversityHospital with documented and valid spirometric measures of lungfunction forced vital capacity (FVC), FEV1, and FEF25–75.Results were compared as differences of FEV1 % predicted and FEF25–75% predicted at the beginning and at end of an IV antibiotic course.Results were analyzed using paired t-tests. P values <0.05 wereconsidered statistically signiﬁcant. Statistical analysis was performedand correlated with others clinical variables studied.Results: 35 IV antibiotic courses from 18 CF patients aged between 6 and17 years were examined. Valid lung function courses were identiﬁed.Intravenous antibiotic treatment given to CF paediatric patients resultedin a signiﬁcant improvement of FEV1 % predicted (p 0.002) and FEF25–75% predicted (p 0.024) in lung function when patients are treated.Duration of antibiotic treatment didn’t have any correlation with thisimprovement (Pearson correlation −0.00019).Conclusion: This study demonstrates a signiﬁcant improvement inFEV1 % predicted and FEF25–75 % predicted to antibiotic IV treatmentin paediatric CF patients.127Collateral sensitivity cycling of antibiotics for cystic ﬁbrosis airwayinfectionsL.M. Sommer1, L. Imamovic2, T. Pressler3, M.O. Sommer2, S. Molin2,4,H.K. Johansen1,2. 1Rigshospitalet, Department of Clinical Microbiology,Copenhagen, Denmark; 2Technical University of Denmark, Novo NordiskFoundation, Center for Biosustinability, Hørsholm, Denmark; 3Rigshopitalet,Copenhagen, Denmark; 4Technical University of Denmark, Department ofSystems Biology, Lyngby, DenmarkObjectives: The main cause of morbidity and mortality in cysticﬁbrosis (CF) patients is bacterial airway infections, and to combatthese infections the patients are treated with large amounts ofantibiotics. Despite the treatments, the infections (in particular byPseudomonas aeruginosa) persist. P. aeruginosa is inherently resistantto many antibiotics and develops multi-resistance over time, resultingin major limitations of antibiotic treatment possibilities. Therefore wepropose the use of antibiotic “Collateral drug cycling” for treatmentof both initial persistent infections as well as chronic infections withP. aeruginosa.Methods: Treatment of CF patients with the collateral drug cyclingapproach is a way to secure a continued treatment of the infection,with lower risks of creating resistant bacterial populations.Results: For P. aeruginosa reference strain PAO1 collateral sensitivity hasbeen found, where e.g. treatment with Ciproﬂoxacin and Aztreonamresults in decreased resistance towards Tobramycin. This will be furthertested in P. aeruginosa clinical isolates from multiple CF patients andshould be directly applicable for the design of new treatment strategies.Conclusion: If the collateral sensitivity can be translated directly toclinical treatment regimes, this is speciﬁcally useful for the treatmentof chronically infected CF patients. This antibiotic treatment approachwill also be applicable in other infection scenarios where resistanceagainst one or multiple antibiotics has occurred.128Antimicrobial susceptibility of Pseudomonas aeruginosa in VilniusCF children centre, LithuaniaV. Radziuniene1, O. Kinciniene2, P. Kalibatas2. 1Vilnius City ClinicalHospital, Vilnius, Lithuania; 2Vilnius University, Faculty of Medicine,Vilnius, LithuaniaObjectives: In this study our objective was to analyse the frequencyof microorganisms and composition of antimicrobial susceptibility ofisolated Pseudomonas aeruginosa.Methods: 97 sputum samples or cough swab or BAL were obtained from30 patients under 18 years old (2–17 years) during 1 year period – fromJanuary to December 2015. 81 samples were positive with 31 differentspecies and were tested for isolation, identiﬁcation and antimicrobialsusceptibility.Results: Out of all positive samples the most common pathogens wereS. aureus – 51.85%. Pseudomonas aeruginosa was isolated in 50.62%of samples. 34.15% of Pseudomonas aeruginosa is detected as mucoidform. 100% of Pseudomonas aeruginosa strains were susceptible tocolistin, 76.6% to ciproﬂoxacin, 76% to imipenem, 56% to ceftazidim,54% to piperacillin, 50% to tobramycin, 33.3% to amikacin. Pseudomonasaeruginosa resistance to gentamicin is 67.3%, to amikacin 51.5%,to tobramycin 50%.Conclusion: The most common isolated pathogens were found to beS. aureus and Pseudomonas aeruginosa. High resistance to medicationsused in ﬁrst line Pseudomonas aeruginosa infection treatment suggestthe need to adapt our treatment regimens to more suitable ones.129Susceptibility of Staphylococcus aureus isolates from patients withand without cystic ﬁbrosis to ceftobiproleD. Gilpin1, G. Carson1, A. Lee1, S. McGrath1, J.S. Elborn1, M.M. Tunney1.1Queens University Belfast, Belfast, United KingdomIntroduction: Ceftobiprole is a broad spectrum “5th generation”cephalosporin antibiotic, which has demonstrated activity againstGram-positive cocci, including Meticillin sensitive and resistantStaphylococcus aureus (MSSA and MRSA). This study aimed to comparethe susceptibility of a range of MSSA and MRSA isolates from both CFand non-CF patients, to ceftobiprole and comparator antibiotics.Methods: The susceptibility of MSSA (CF: n =25; non-CF: n =24) andMRSA (CF: n =24; non-CF: n =29) isolates to ceftobiprole, linezolid,rifampicin and vancomycin was determined using E-test® strips withminimum inhibitory concentrations read after 24h of incubation at37oC. Where possible, isolates with a diverse genetic background wereselected for inclusion in this study. Isolates were classiﬁed as eithersusceptible, intermediate or resistant to each antibiotic in accordancewith Clinical and Laboratory Standards Institute breakpoints.Results: No MSSA isolates tested were resistant to any of the antibioticstested. Of the MRSA isolates tested, 3/53 (5.6%), all from CF patients,were resistant or intermediately resistant to rifampicin.

Collateral sensitivity cycling of antibiotics for cystic fibrosis airway

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Collateral sensitivity cycling of antibiotics for cystic fibrosis airway

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