Trends in pathogens colonising the respiratory tract of adult patients with cystic fibrosis, 1985-2005.

J Cyst Fibros. 2009 Sep 7. [Epub ahead of print]

Trends in pathogens colonising the respiratory tract of adult patients with cystic fibrosis, 1985-2005.

Millar FA, Simmonds NJ, Hodson ME.

Adult Cystic Fibrosis Dept, NHLI/Imperial College and Royal Brompton Hospital, London, United Kingdom.

INTRODUCTION: The treatment of patients with CF has continued to evolve. We hypothesised that sputum microbiology may have changed as a result of this.

METHOD: Retrospective analysis of sputum microbiology from adult CF patients (1985 to 2005) using the Royal Brompton Hospital CF database.

RESULTS: Colonisation with Pseudomonas aeruginosa or Staphylococcus aureus between 1985 and 2005 remained stable (77 to 82%, p=0.159; 54 to 47%, p=0.108; respectively). Haemophilus influenzae (48 to 6%; p<0.001), Aspergillus species (18 to 9%; p=0.002) and Burkholderia cepacia complex (9 to 4%; p=0.041) prevalence decreased. Stenotrophomonas maltophilia and MRSA increased (1 to 4%, p=0.02; 1 to 6%, p=0.002, respectively).

CONCLUSION: P. aeruginosa colonisation has remained stable; there has been a decline in B. cepacia complex, H. influenzae and Aspergillus sp., and only a small increase in S. maltophilia and MRSA. Intensive antibiotic strategies have been employed, which, so far, have not resulted in clinically significant emergence of new pathogens.