RESUMEN
Pseudomonas aeruginosa is the leading pathogen in cystic fibrosis (CF) lungs. Since there is great concern about clonal spread in CF centres, this study examined the P. aeruginosa genotypes of colonised residents of a CF rehabilitation centre. The isolates from the sputum of 76 P. aeruginosa-colonised patients were genotyped by fluorescent amplified fragment length polymorphism on arrival and departure. A total of 71 different P. aeruginosa genotypes were identified from 749 isolates. Forty-nine patients had one genotype, 20 had two genotypes and seven had three. Forty-four patients had one or more genotypes in common with other patients (i.e. cluster types). Thirty-two patients were colonised by a single genotype not shared by any other patient. Thirty-eight of the 44 patients with a cluster type already carried their cluster type strain(s) on arrival. Patient-to-patient transmission could not be excluded for eight patients. For five of these, this infection was transient. None of the environmental P. aeruginosa isolates had a genotype similar to the patients' genotypes. In summary, most patients were colonised by only one or two P. aeruginosa genotypes and the risk of persistent patient-to-patient transmission was low during the study period (4%). Most patients with a cluster-type strain carried this strain on arrival, indicating that transmission could have happened in the past. No environmental contamination could be established.
Asunto(s)
Fibrosis Quística/rehabilitación , Infecciones por Pseudomonas/epidemiología , Infecciones por Pseudomonas/microbiología , Centros de Rehabilitación/estadística & datos numéricos , Adolescente , Adulto , Técnicas de Tipificación Bacteriana , Bélgica/epidemiología , Niño , Preescolar , Comorbilidad , Fibrosis Quística/epidemiología , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Femenino , Genotipo , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Infecciones por Pseudomonas/transmisión , Pseudomonas aeruginosa/aislamiento & purificación , Medición de Riesgo , Esputo/microbiologíaRESUMEN
We have studied a girl with fibrotic extrinsic eye muscles, Axenfeld anomaly, unusual facial appearance, mild hydrocephaly, and neurodevelopmental delay. Her condition is similar to the one described recently in members of a single family by Chitty et al. [1991, Am J Med Genet 40:417-420]. We suggest that she represents a second example of what may be called the Chitty syndrome.
