The value of serum IgG titres against Pseudomonas aeruginosa in the management of early pseudomonal infection in cystic fibrosis (original) (raw)
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Journal of Clinical Microbiology
Immunoglobulin G (IgG) antibodies to Pseudomonas aeruginosa surface antigens in serum were estimated by enzyme-linked immunosorbent assay for all patients from whom P. aeruginosa was isolated for the first time during a study period of 3 years (33 patients). The titer of IgG antibodies was greater than control values at or up to 24 months before the first isolation of P. aeruginosa in 24 patients. Another five patients had titers that were within the control range before isolation of P. aeruginosa but increased to above the control range within the following 2 months. In these 29 patients, continuing intermittent isolations of P. aeruginosa were accompanied by further increases in titer. The presence of a systemic immune response above the control range indicates tissue invasion and hence infection. Four patients were deemed to have no infection: one or two isolations of P. aeruginosa were accompanied by no increase in specific antibodies to above the control range throughout the en...
Diagnostic Pathology, 2014
Background: The usefulness of serological tests for detection of P. aeruginosa pulmonary infection in cystic fibrosis (CF) is controversial. Here, we assessed the value of detecting anti-P. aeruginosa IgG by a quantitative enzyme-linked immunosorbent assay (ELISA) for identification of P. aeruginosa infection in patients with cystic fibrosis. Methods: Serum concentrations of anti-P. aeruginosa IgG were assessed in 117 CF patients classified according to their P. aeruginosa colonization/infection status (never colonized; free of infection; intermittently colonized and chronically infected) and in 53 healthy subjects by the ELISA test standardized with the St-Ag:1-17 antigen. Results: The rate of IgG seropositivity and the median of IgG concentrations of this antibody in patients chronically infected were significantly higher than those found in the other CF groups and in the healthy control group. Conclusion: Detection of anti-P. aeruginosa IgG can be an useful tool for identification of P. aeruginosa chronic infection in patients with CF. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/ 13000_2014_158
Serum antibodies to Pseudomonas aeruginosa in cystic fibrosis
Archives of Disease in Childhood, 1986
Serum IgG antibodies to Pseudomonas aeruginosa cell surface antigens were determined by enzyme linked immunosorbent assay. Titres in patients without cystic fibrosis were low (140-235). Those in patients with cystic fibrosis who were chronically infected by P. aeruginosa were very high (1100-20 500), while patients who grew the organism intermittently had lower titres (160-4400). Longitudinal studies showed that raised titres were observed at a very early stage of infection. High titres were associated with a poor clinical state, while low titres were associated with a better clinical state in both chronic and intermittently infected patients with cystic fibrosis. These results suggest that this test is a specific and sensitive measure of the severity and progress of the different stages of pulmonary infection by P. aeruginosa in patients with cystic fibrosis.
Serum IgA antibodies against Pseudomonas aeruginosa in cystic fibrosis
Archives of Disease in Childhood, 1990
Serum IgA antibodies to Pseudomonas aeruginosa cell surface antigens were estimated by ELISA. Titres in patients with and without cystic fibrosis and with no pseudomonal infection were low (<105 to <261). Titres in patients with cystic fibrosis who were chronically infected with P aeruginosa were very high (1200-163 000), and patients who grew the organism intermittently had intermediate titres.
Journal of Cystic Fibrosis, 2019
Background: Definition of Pseudomonas aeruginosa (Pa) microbiological status is essential for patients' inclusion in clinical trials. The aim of this study was to agree on the definitions of Pa infection status for initial infection, eradication and chronic infection to be used in clinical trials and to propose additional future study areas. Methods: An exhaustive literature search was performed. The clinimetric properties of different definitions of Pa microbiological status were evaluated. Results: Historical studies have mostly used culture-based definitions, although some have also involved complementary anti-Pa antibodies. Clinimetric analysis showed great variability in the definitions used, leading to differences in reliability, validity, responsiveness to treatment and correlation with outcome measures. Use of serology for initial Pa infection and successful Pa eradication introduced a greater level of complexity as antibody tests are not standardised. Moreover, the chronology of the immune response to Pa antigenic determinants was not completely clear. Chronic Pa infection was characterized by high levels of antibodies and good concordance between culture results and serology. Conclusions: Microbiological monitoring, regular sampling from the airways and standardization of culture methods remain essential requisites for microbiological definitions. Despite limitations, serology should be incorporated in the definitions of initial infection and eradication used in clinical trials to better classify patients at enrolment, mainly in non-expectorating children. This requires standardization of serological testing.
Journal of Cystic Fibrosis, 2003
Background: Patients were defined each successive month as either 'chronic' when more than 50% of the preceding 12 months were PA culture positive, 'intermittent' when F50% of the preceding 12 months were PA culture positive, 'free of PA', with no growth of PA for the previous 12 months, having previously been PA culture positive, or 'never infected', when PA had never been cultured. Methods: Cross-sectional analysis of 146 children attending the Leeds Regional Cystic Fibrosis Centre was performed to assess relationship between the new definition and clinical scores and investigations. The response variable was regressed on age and sex and the residuals analysed using the Kruskal-Wallis test. Results: The 'chronic' group (18% of patients) had significantly worse Shwachman-Kulczycki (SK) and Northern chest X-ray scores, and % predicted FEV values than the 1 'free' (28%) or 'never' (20%) categories (P-0.004). The 'intermittent' group (34%) had a significantly higher SK score than the 'chronic' group (P-0.0001), and a significantly lower % predicted FEV value than the 'free' or 'never' groups (P-0.0003). 1 'Chronic' patients were significantly associated with a positive, and 'never' patients with a negative, PA antibody result (P-0.001). Conclusions: The validity and importance of identifying these four subgroups is demonstrated. Previous definitions may over-estimate the prevalence of chronic infection.
Serodiagnosis and Immunotherapy in Infectious Disease, 1990
An enzyme-linked immunosorbant assay (ELISA) with urease enzyme was developed with either a polyvalent pseudomonas smooth lipopolysaccharide (LPS) extract vaccine (PEV-02) or rough LPS (R-LPS) from P. aeruginosa rough mutant PAC605. Each ELBA was able to differentiate between sera from cystic fibrosis (CF) patients chronically colonized with P. aeruginosa and sera from non-colonized patients. Sera from non-colonized and intermittently colonized CF patients seldom reacted with any of the Pseudomonas LPS, whereas sera from chronically colonized CF patients reacted strongly with most of the sixteen smooth 0-serotype vaccine components and with the PAC605 R-LPS, indicating the presence either of a number of different serotype specific IgG antibodies and/or IgG antibodies directed to a common antigenic component of LPS rough core. Absorption studies and immunoblot analysis demonstrated that in sera from CF patients who were chronically colonized with P. aerugiiosa a significant component of the anti-P. aeruginosa antibodies is specific for the core of P. aeruginosa LPS and cross reactive with a number of serotypes of P. aeruginosa LPS.
The Turkish journal of pediatrics
In cystic fibrosis (CF), if Pseudomonas aeruginosa (Pa) infection is not diagnosed and treated early, chronic colonization occurs, which causes rapid decline in pulmonary functions. The aim of this study was to evaluate Pa antibodies, compare them with Pa cultures and determine their role in early diagnosis and follow-up. Ninety CF patients were included; they were divided into chronic, intermittent, negative, and mucoid groups. They were evaluated every 3-6 months. In each visit, pulmonary function tests and sputum cultures were obtained, and Pa antibodies exotoxin A (ExoA), elastase (ELA) and alkaline protease (AP) were determined in the serum by enzyme-linked immunosorbent assay (ELISA). The most specific test that discriminated chronic colonized patients from noncolonized patients was Pa culture, and the presence of at least one antibody had the highest sensitivity. AP had the highest specificity, and ELA had the highest sensitivity. All antibodies were highest in the mucoid gro...
Early eradication therapy against Pseudomonas aeruginosa in cystic fibrosis patients
European Respiratory Journal, 2005
In cystic fibrosis (CF) patients early antibiotic treatment of lung infection has been shown to lead to Pseudomonas aeruginosa eradication. The present study determined: 1) the time period from eradication to new P. aeruginosa acquisition; 2) P. aeruginosa re-growth and new acquisition; and 3) the impact of eradication therapy on lung function, antimicrobial resistance, emergence of other pathogens and treatment costs.
2020
Introduction and Objective: Microbiological surveillance guides the antibiotic therapy that plays an important role in maintaining the cystic fibrosis (CF) patients in stable clinical condition. Materials and Method: Respiratory samples (495 sputum, 711 deep pharyngeal swab) from 253 CF patients aged 0-43 were cultivated in conventional media and cumulative antibiogram was determined. A 24 questioned survey was applied to 119 patients for a 3 months period to measure demographic variabilities and knowledge about infection control. Results: The most common pathogen was Pseudomonas aeruginosa (45.7%), followed by Staphylococcus aureus (36%). P. aeruginosa was isolated from 60% of sputum samples and 28.5% of deep pharyngeal swab samples. High rate of resistance was detected to ceftazidime, amikacin and ciprofloxacin that are often preferred in treatment. Low monthly income, more than 9 visits to CF clinic in the last year, hospitalisation in the last year, spending more than 3 hours in...