Jones A M, Martin L, Bright-Thomas R J, Dodd M E, McDowell A, Moffitt K L, Elborn J S, Webb A K
Manchester Adult Cystic Fibrosis Centre, South Manchester University Hospitals NHS Trust, Manchester, UK.
Eur Respir J. 2003 Sep;22(3):503-6. doi: 10.1183/09031936.03.00004503.
Chronic Pseudomonas aeruginosa infection in cystic fibrosis (CF) leads to a damaging host inflammatory response. There are an increasing number of reports of P. aeruginosa cross-infection at CF centres. The clinical significance of acquisition of a transmissible strain for patients who already harbour P. aeruginosa is unclear. In this study, levels of inflammatory markers in clinically stable adult CF patients who harbour transmissible and sporadic strains of P. aeruginosa have been compared. Patients with CF and chronic P. aeruginosa infection were grouped into those who harbour a transmissible P. aeruginosa and those who harbour their own sporadic strains. Total white cell and differential counts, sputum neutrophil elastase (NE), interleukin (IL)-8, tumour necrosis factor (TNF)-alpha, plasma IL-6 and NE/alpha1-antitrypsin complexes, serum C-reactive protein, and urine TNF receptor 1 were all measured in clinically stable patients 4-6 weeks following completion of intravenous antibiotic therapy. The two groups (both n=20) were well matched for per cent predicted forced expiratory volume in one second, per cent predicted forced vital capacity and body mass index. There were no significant differences in levels of white cell counts or inflammatory markers between the two groups. At times of clinical stability, cystic fibrosis patients infected with transmissible Pseudomonas aeruginosa do not have a heightened inflammatory response above that of those harbouring sporadic strains.
囊性纤维化(CF)患者的慢性铜绿假单胞菌感染会引发有害的宿主炎症反应。越来越多关于CF中心铜绿假单胞菌交叉感染的报道出现。对于已经感染铜绿假单胞菌的患者而言,获得可传播菌株的临床意义尚不清楚。在本研究中,对携带可传播菌株和散发菌株的临床稳定成年CF患者的炎症标志物水平进行了比较。患有CF和慢性铜绿假单胞菌感染的患者被分为携带可传播铜绿假单胞菌的患者和携带自身散发菌株的患者。在静脉抗生素治疗结束后的4 - 6周,对临床稳定患者测量了总白细胞和分类计数、痰中性粒细胞弹性蛋白酶(NE)、白细胞介素(IL)-8、肿瘤坏死因子(TNF)-α、血浆IL-6和NE/α1 -抗胰蛋白酶复合物、血清C反应蛋白以及尿TNF受体1。两组(每组n = 20)在一秒用力呼气量预测值百分比、用力肺活量预测值百分比和体重指数方面匹配良好。两组之间白细胞计数或炎症标志物水平没有显著差异。在临床稳定期,感染可传播铜绿假单胞菌的囊性纤维化患者的炎症反应并不高于携带散发菌株的患者。