Microbiological diagnostic procedures for respiratory cystic fibrosis samples in Spain: towards standard of care practices.

Juan De Dios Caballero,Marta Cobo,Elia Gómez G De La Pedrosa,Carla López-Causapé,Rosa Del Campo,Antonio Oliver,Enrique Gómez-Mampaso,Marta Tato,Rafael Cantón,Spanish Network For Cystic Fibrosis Microbiology Laboratories

doi:10.1186/s12866-014-0335-y

Abstract

BackgroundThe microbiological procedures for cystic fibrosis (CF) samples of 17 participating Spanish centers were examined to verify their compliance with current international and national guidelines and to implement the best standards of care for microbiology practices. A 47-item questionnaire covering different CF microbiology aspects was sent to participant laboratories. Telephone interviews were performed when necessary. Data about samples processing for bacteria, mycobacteria and fungi were collected.ResultsGene sequencing (71%), MALDI-TOF (59%) or both (94%) were available for most laboratories. Susceptibility testing was performed by automated microdilution systems (94%) and manual diffusion methods (59%). However, a low use of selective media for Staphylococcus aureus (59%) and Burkholderia cepacia complex (71%), and of epidemiological typing methods (41%) was reported.ConclusionsMost Spanish laboratories are in agreement with consensus guidelines for the processing of CF respiratory samples, but need to improve in the use of specific selective media and typing methods for epidemiologic studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-014-0335-y) contains supplementary material, which is available to authorized users.

Highlights

The microbiological procedures for cystic fibrosis (CF) samples of 17 participating Spanish centers were examined to verify their compliance with current international and national guidelines and to implement the best standards of care for microbiology practices
The number of CF patients attended by these centers is 2,315 (Table 1), which represents 75% of the CF Spanish population according with the last European Cystic Fibrosis Society (ECFS) report [15]
In summary, there are few studies regarding the assessment of microbiological procedures in CF samples and this is the first one performed in our country [12,13,17]

Summary

Introduction

The microbiological procedures for cystic fibrosis (CF) samples of 17 participating Spanish centers were examined to verify their compliance with current international and national guidelines and to implement the best standards of care for microbiology practices. Altered CFTR leads to the production of viscous secretions in respiratory airways that cannot be cleared by the mucociliary system and patients get chronically colonized by different microorganisms (bacteria, mycobacteria and fungi) which cause inflammation, progressive lung destruction and, death by respiratory failure [1]. Microbiological diagnosis of CF has evolved far beyond the isolation and identification of classic pathogens such as Pseudomonas aeruginosa and Staphylococcus aureus [2]. Phenotypic changes to the CF lung, including smallcolony variants (SCVs) and hyper-mutable and mucoid strains variants Correct diagnosis of these phenotypic variants is difficult and has clinical relevance as there is growing evidence that correlates them with multi-drug resistance, persistency phenomena and poorer lung function [6,7,8,9]. Accurate isolation, identification and susceptibility testing of CF pathogens are critical for ensuring appropriate treatment and implementation of infection control measures, and for improving our understanding of CF microbiology [10,11,12,13,14]

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