AtbFinder Diagnostic Test System Improves Optimal Selection of Antibiotic Therapy in Persons with Cystic Fibrosis

Authors

G Tetz, Human Microbiology Institute, New York, New York, USA.
K Kardava, Human Microbiology Institute, New York, New York, USA.
M Vecherkovskaya, Human Microbiology Institute, New York, New York, USA.
A Hahn, Division of Infectious Diseases, Children's National Hospital (CNH), Washington, District of Columbia, USA.
M Tsifansky, Department of Pediatrics, George Washington University (GWU), Washington, District of Columbia, USA.
A Koumbourlis, Division of Pulmonary and Sleep Medicine, Children's National Hospital, Washington, District of Columbia, USA.
V Tetz, Human Microbiology Institute, New York, New York, USA.

Document Type

Journal Article

Publication Date

1-26-2023

Journal

Journal of clinical microbiology

Volume

61

Issue

1

DOI

10.1128/jcm.01558-22

Keywords

FEV; MDR; P. aeruginosa; antibiotics; cystic fibrosis; pulmonary exacerbations

Abstract

Cystic fibrosis (CF) is characterized by mutations of CFTR that lead to increased viscous secretions, bacterial colonization, and recurrent infections. Chronic Pseudomonas aeruginosa infection in persons with CF is associated with progressive and accelerated lung function decline despite aggressive antibiotic treatment. We report the management of respiratory infections in persons with CF with antibiotic therapy that was based on the recommendations of AtbFinder, a novel, rapid, culture-based diagnostic test system that employs a novel paradigm of antibiotic selection. AtbFinder mimics bacterial interactions with antibiotics at concentrations that can be achieved in affected tissues or organs and models conditions of interbacterial interactions within polymicrobial biofilms. This open-label, single-arm, investigator-initiated clinical study was designed to identify the efficacy of antibiotics selected using AtbFinder in persons with CF. Microbiological and clinical parameters were assessed following the change of antibiotic therapy to antibiotics selected with AtbFinder between January 2016 and December 2018 and retrospectively compared with clinical data collected between January 2013 and December 2015. We enrolled 35 persons with CF (33 with chronic P. aeruginosa colonization). Antibiotics selected using AtbFinder resulted in clearance of P. aeruginosa in 81.8% of subsequent cultures, decreased pulmonary exacerbations from 1.21 per patient per annum to 0, and an increase in predicted percent predicted forced expiratory volume in 1 s up to 28.4% from baseline. The number of systemic antibiotic courses used in patients after switching to the AtbFinder-selected therapy was reduced from 355 to 178. These findings describe the superiority of antibiotic regimens selected with AtbFinder compared with routine antimicrobial susceptibility testing.

APA Citation

Tetz, G; Kardava, K; Vecherkovskaya, M; Hahn, A; Tsifansky, M; Koumbourlis, A; and Tetz, V, "AtbFinder Diagnostic Test System Improves Optimal Selection of Antibiotic Therapy in Persons with Cystic Fibrosis" (2023). GW Authored Works. Paper 2237.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2237

Department

Pediatrics