Emerging microorganisms in cystic fibrosis.

Pseudomonas aeruginosa is the most common bacterial isolate obtained from patients with cystic fibrosis of the lungs. Recently, however, new multiresistant organisms have emerged, whose identification may be difficult and whose pathogenic role proves hard to define. Of the 71 strains isolated from 24 patients with cystic fibrosis during acute flareups of pulmonary symptoms, 48 turned out to be Pseudomonas aeruginosa (67.6%); 11 were Pseudomonas non-aeruginosa (15.5%); and 12 were Achromobacter xylosoxidans (16.9%). Each bacterial isolate was tested for sensitivity to nine antibiotics (ceftazidime, azlocillin, piperacillin, aztreonam, cefsulodin, cefoperazone, amikacin, tobramycin, and sisomycin) in terms of minimum inhibitory concentration and minimum bactericidal concentration values. In this series, Achromobacter xylosoxidans proved the species least responsive to treatment, and ceftazidime the most active antibiotic both against Achromobacter and against strains of the genus Pseudomonas. Twenty-three different associations of ceftazidime with aminoglycosides, tested for activity on the multiresistant strains, failed to show synergism of action.

Multibranched chromosomes 1, 9, and 16 in a patient with combined IgA and IgE deficiency.

Instability of the centromeric region of chromosome 1 and multibranched configurations formed by different numbers and combinations of arms of chromosomes 1, 9, and 16 were found in cultured lymphocytes of a 12-year-old male with combined IgA and IgE deficiency. No chromosome abnormalities were found in fibroblast cultures from the patient or in blood cultures from his parents. A possible effect on the frequency of the abnormalities of the almost continuous antibiotic treatment received by the patient was found both in vivo and in vitro, but no abnormalities were found in blood cultures from control subjects who received similar treatment. Interphase association of chromosomes 1, 9, and 16 and a high frequency of interchanges among the centromeric regions of these chromosomes due to the presence of a fragile site is assumed to be the cause of the abnormalities.

[Microbiology of chronic lung diseases in children (author's transl)]. / Microbiologia delle broncopneumopatie croniche dell'eta' pediatrica

The bacterial flora was studied in the bronchial, pharyngeal secretions and sputum of 80 children with Cystic Fibrosis (CF) and of 21 children with other chronic lung diseases, treated at the Pediatric Clinic (Respiratory Unit), University of Genoa. Staphylococcus aureus was found in 52% of patients, Pseudomonas aeruginosa in 48%, Proteus in 5%. According to the age, the patients have been distinguished into four groups; in the 6-10 and 11-15 year-old group Staphylococcus aureus was the commonest pathogen isolated, while Pseudomonas aeruginosa was found much more commonly in the 16-20 year-old group. Details are given of antibiotic-sensitivity for single strains grown. Intensive care programs, based on specific antibiotic-sensitivity, for in-patients and out-patients, are reported: positive results in treatment courses with Gentamicin, Cephalosporins and Tobramycin are presented.