[Generation of Antibiotic Tolerant Bacterial Persisters in Immunocompromized Patients with Hematologic and Malignant Diseases: A New Problem of Health-Care Associated Infections]

Vestn Ross Akad Med Nauk. 2016;71(3):183-9.
[Article in Russian]

Abstract

Background: Antibiotic tolerance (AT) represents one of the causes of the phenomenon of antibiotic resistance that allows escape of non-replicating metabolically inert microorganisms (persisters) from any antibiotics attack because molecular targets of antibiotics are lacking thereby creating the potential for chronic infections.

Aims: Determine the heterogeneity of the strains of opportunistic pathogens E. coli and P. aeruginosa isolates from children with hematologic malignancies containing bacterial persisters that cause the AT phenomenon.

Methods: Children with hematological malignancies were divided into 2 groups according to the intensity of antibiotic treatment of infectious complications. Ciprofloxacin-induced persisters were quantitatively determined in the biological materials obtained from sick children.

Results: Within the clinical isolates of E. coli and P. aeruginosa, about a third of the strains belong to high-persisting. The numbers of persistent forms of bacteria did not correlate with a minimal inhibitory concentration values ciprofloxacin (r=0.148, n=25, p>0.05). Interestingly, higher level of formation of persistent E. coli and P. aeruginosa, is associated with higher frequencies of infection attacks, massive antibiotic use and unfavorable course of the disease in children.

Conclusions: Therefore, detecting the persistent forms of bacterial pathogens including those associated with the health-care associated infection, specifically, in immunocompromised patients, should be included into the contemporary algorithms of microbiological observation and monitoring of patients and intrahospital environment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Ciprofloxacin / therapeutic use*
  • Cross Infection / prevention & control
  • Drug Resistance, Microbial / drug effects
  • Drug Tolerance*
  • Escherichia coli* / drug effects
  • Escherichia coli* / isolation & purification
  • Female
  • Hematologic Neoplasms* / complications
  • Hematologic Neoplasms* / microbiology
  • Humans
  • Immunocompromised Host / drug effects
  • Male
  • Microbial Sensitivity Tests / methods
  • Opportunistic Infections* / diagnosis
  • Opportunistic Infections* / drug therapy
  • Opportunistic Infections* / etiology
  • Pseudomonas aeruginosa* / drug effects
  • Pseudomonas aeruginosa* / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Ciprofloxacin