Probiotics and exacerbations

Other than the prevention/treatment of C Diff, looks like these buggers may help prevent exacerbations. 

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Pediatr Pulmonol. 2010 Jun;45(6):536-40. doi: 10.1002/ppul.21138.

Probiotic supplementation affects pulmonary exacerbations in patients with cystic fibrosis: a pilot study.

Weiss B, Bujanover Y, Yahav Y, Vilozni D, Fireman E, Efrati O.

Source

Division of Pediatric Gastroenterology and Nutrition, Safra Children's Hospital, Tel-Hashomer, Israel. weissb@sheba.health.gov.il

Abstract

OBJECTIVE:

Probiotics reduce intestinal inflammation in, and Lactobacillus GG (LGG) reduces pulmonary exacerbation rate cystic fibrosis (CF) patients. We intended to determine the effect of a mixed probiotic preparation on pulmonary exacerbations and inflammatory characteristics of the sputum in CF patients.

STUDY DESIGN:

A prospective pilot study of 10 CF patients with mild-moderate lung disease and Pseudomonas aeruginosa colonization, treated with probiotics for 6 months. Pulmonary function tests (PFT's), sputum cultures with semi-quantitative bacterial analysis, and sputum neutrophil count and interleukin-8 (IL-8) levels were compared to pre-treatment and post-treatment values. The rate of pulmonary exacerbations was compared to 2 years prior to the study.

RESULTS:

The exacerbation rate was significantly reduced in comparison to the previous 2 years and to 6 months post-treatment (P = 0.002). PFT's have not changed at the end of treatment and during 6 months post-treatment. No change in sputum bacteria, neutrophil count, and IL-8 levels was observed.

CONCLUSION:

Probiotics reduce pulmonary exacerbations rate in patients with CF. Probiotics may have a preventive potential for pulmonary deterioration in CF patients.

PMID:

20503277

 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/20503277

MDRPA to MDSPA

In July 2011, I was so bummed to be admitted to the hospital with very, very few antibiotic options to treat my PA. Basically I had colistin and sorta kinda beta-lactams (intermediate resistance). Not too fun.

Well, thanks to the amazing wisdom of Ms. Mandy - who is always giving me great ideas), I have been taking Chilated Magnesium every day since October.

And in clinic on Jan 12, for the first time in 3 years, my clinic took me off isolation because I no longer have multi-drug resistant PA. Meaning all 3 of my PA strains are susceptible to nearly all classes of antibiotics (one strain is resistant to one class).

Talk about amazing. Incredible. Truly, a God-send.



Here are some studies supporting this outcome (thank you to Mandy's blog for these references):

Proteomic analysis of Pseudomonas aeruginosa grown under magnesium limitation.

Guina T, Wu M, Miller SI, Purvine SO, Yi EC, Eng J, Goodlett DR, Aebersold R, Ernst RK, Lee KA.

Department of Pediatrics, Division of Infectious Diseases, University of Washington, Seattle, Washington 98195, USA. tguina@u.washington.edu 

In this study, large-scale qualitative and quantitative proteomic technology was applied to the analysis of the opportunistic bacterial pathogen Pseudomonas aeruginosa grown under magnesium limitation, an environmental condition previously shown to induce expression of various virulence factors. For quantitative analysis, whole cell and membrane proteins were differentially labeled with isotope-coded affinity tag (ICAT) reagents and ICAT reagent-labeled peptides were separated by two-dimensional chromatography prior to analysis by electrospray ionization-tandem mass spectrometry (ESI-MS/MS) in an ion trap mass spectrometer (ITMS). To increase the number of protein identifications, gas-phase fractionation (GPF) in the m/z dimension was employed for analysis of ICAT peptides derived from whole cell extracts. The experiments confirmed expression of 1331 P. aeruginosa proteins of which 145 were differentially expressed upon limitation of magnesium. A number of conserved Gram-negative magnesium stress-response proteins involved in bacterial virulence were among the most abundant proteins induced in low magnesium. Comparative ICAT analysis of membrane versus whole cell protein indicated that growth of P. aeruginosa in low magnesium resulted in altered subcellular compartmentalization of large enzyme complexes such as ribosomes. This result was confirmed by 2-D PAGE analysis of P. aeruginosa outer membrane proteins. This study shows that large-scale quantitative proteomic technology can be successfully applied to the analysis of whole bacteria and to the discovery of functionally relevant biologic phenotypes. 

PMID: 12837596 [PubMed - indexed for MEDLINE] 

New Method Attacks PA

New Method Attacks Bacterial Infections on Contact Lenses

ScienceDaily (Jan. 25, 2011) — Researchers at National Jewish Health and the University of Texas Southwestern Medical Center have discovered a new method to fight bacterial infections associated with contact lenses. The method may also have applications for bacterial infections associated with severe burns and cystic fibrosis. The results were published online January 18 in the journalInvestigative Ophthalmology and Visual Science.

"Infections by the bacteriaPseudomonas aeruginosa can cause severe scarring and vision loss when they spread to the cornea," said senior author Jerry Nick, MD, Associate Professor of Medicine at National Jewish Health. "By breaking apart a molecular scaffolding that encases the organisms and makes them more difficult to eradicate, we were able to significantly reduce bacterial infection of the cornea."

The eye normally fights infections through a variety of defense mechanisms including blinking of the eyes, which helps remove bacterial organisms from the surface of the eye. Contact lenses, however, inhibit the effectiveness of blinking eyelids.

Thus, bacteria can adhere to the surface of the contact lens that sits against the eye. If those bacteria infect the corneal surface they can destroy the delicate corneal cells, which can lead to scarring and vision loss. The condition is known as microbial keratitis, and affects about two to four lens wearers per 10,000 each year.

Eye infections can be treated with antibiotics. However, it can be difficult to eliminate the bacteria on the contact lenses, especially when they form a biofilm. A biofilm is a matrix that harbors and encases communities of the organisms, making them harder to eradicate.

The researchers confirmed earlier findings that cellular debris from immune cells fighting the infection actually provide the raw materials for the biofilm -- DNA, actin and histones. So, they used the enzyme DNAase together with negatively charged poly aspartic acid to break down the chemical bonds of these elements that support the biofilm.

This treatment reduced biofilms on the contact lenses by 79.2 percent. The same treatment reduced infection of the cornea in an animal model by 41 percent. There was no evidence of any harm caused by the treatments. (Abstract)

"These are very promising early results that point to potentially new methods for removing bacterial biofilms from contact lens surfaces, thereby reducing the risk of microbial keratitis, as well as the for the treatment of infections by Pseudomonas that are associated with cystic fibrosis and severe burns,' said Danielle Robertson, OD, PhD, first author and Assistant Professor of Ophthalmology at UT Southwestern, and first author on the study.