The control of pulmonary infection in patients with cystic fibrosis

Drain, Mildred (1980) The control of pulmonary infection in patients with cystic fibrosis. MSc(R) thesis, University of Glasgow.

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Abstract

Sixteen patients with cystic fibrosis were monitored for eighteen months by monthly bacteriological examination of nose and throat swabs and sputum in order to determine if better control of respiratory infection could be achieved by more rational usage of antibiotics. The patients were divided into two groups; a Variable Antibiotic group and a Flucloxacillin group. The first group received only one antibiotic which was initially chosen and then changed as culture results dictated, while the second group was given continuous anti-staphylococcal chemoprophylaxis plus one other antibiotic if required, but the latter for a period of 10 days only. Weight, height, and radiological data showed that in both groups of patients the clinical status did hot alter significantly from the start of the investigation, although no deterioration was observed. However, the number of hospital admissions, which reflected exacerbation of pulmonary infection, was greatly reduced in both groups during the 18 months of the investigation. The predominant organism isolated from both groups was Staphylococcus aureus. However, in patients with severe pulmonary involvement, both S. aureus and Pseudomonas aeruginosa occurred. This agrees with previous findings that the main organisms associated with respiratory problems in CF patients are S. aureus and P. aeruginosa, despite the presence of other bacterial species in the respiratory tract. Control of S. aureus and Haemophilus Influenzae infection was significantly better in the Flucloxacillin group, but neither these organisms nor P. aeruginosa were completely eradicated. Antibiotic sensitivity tests indicated that bacterial isolates from CF patients were, in general, more sensitive to antibiotics than the same species from non-CF patients. This greater incidence of antibiotic-susceptible bacterial isolates from CF patients, as compared with non-CF patients in a children's hospital, has not previously been reported. This lesser degree of antibiotic resistance was thought to be due to lower selection pressure on the organisms. The mucoid strain of P. aeruginosa showed greater susceptibility to certain antibiotics than the rough strain - a point on which previous investigations have been divided. Phage-typing of the S. aureus isolates from the CF patients revealed that the upper respiratory tract was not the source of this organism in pulmonary infection. No evidence was found to suggest the predominance of any single phage-type, although each patient usually harboured S. aureus from one phage-group.

Item Type: Thesis (MSc(R))
Qualification Level: Masters
Additional Information: Adviser: W Hamilton
Keywords: Pathology
Date of Award: 1980
Depositing User: Enlighten Team
Unique ID: glathesis:1980-71972
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 17 May 2019 13:35
Last Modified: 17 May 2019 13:35
URI: http://theses.gla.ac.uk/id/eprint/71972

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