Abolition of Pseudomonas aeruginosa AUST-01 from an Australian CF center: Do other strains remain?

Abstract

We read with interest the article published recently in the Journal by Kevat et al.1 from Melbourne Australia describing the elimination of an epidemic (shared) Pseudomonas aeruginosa strain from their pediatric cystic fibrosis (CF) center. Prolonged shared P. aeruginosa strain infections in patients attending CF centers were first recognized in Liverpool in the United Kingdom during the early 1990's when molecular typing techniques identified a single indistinguishable P. aeruginosa strain in 55 of 65 (85%) children infected with this pathogen.2 Shortly afterwards, a shared P. aeruginosa strain that was genetically unrelated to the Liverpool Epidemic strain was also found in infants and young children with CF participating in a prospective birth cohort study in Melbourne.3 Subsequently, several key publications from this center highlighted the importance of this strain, now known as AUST‐01 (aka AES1). These included its original prevalence in the center (55% of P. aeruginosa positive children), its association with increased morbidity and mortality in very young children, and that with the introduction of cohort segregation (AUST‐01 positive patients separated from cohorted patients harboring non‐AUST‐01 strains) a significant and sustained reduction in center prevalence of AUST‐01 was observed between 1999, 2002, and 2007 (21%, 14%, and 6%), respectively.3-5