Features of the treatment of the cystic fibrosis patient with mixed microbial respiratory infection, including Pandoraea Pnomenusa

Respiratory tract infection is a major cause of complications and death in patients with cystic fibrosis (CF). Transmissible strains of Gram-negative non-fermenting Burkholderiales bacteria: Burkholderia cepacia complex, Achromobacter spp, Pandoraea spp. are quite alarming. In the paperfirstly there is presented a clinical case with mixed microbial infection of the CF patient with involvement of Pandoraea pnomenusa. There are reportedfeatures of diagnosis and treatment of a patient throughout 20 years, described the data of the examination of the patient and his airway microbiota. Timely identification of P. pnomenusa with the use of mass spectrometry MALDI-TOF and the molecular genetic techniques was shown to contribute to the isolation of the patient in the hospital, his transfer to the inpatient substitution therapy, that prevented the cross-infection of other CF patients. Permanent microbiological control revealed an increase of the antibiotic resistance of P. pnomenusa. The congruence of the antibiotic therapy with resistome of all identified microorganisms has allowed to develop an effective treatment schedule, which promoted to the elimination of P. aeruginosa and P. pnomenusa in the sputum of CF patients to minor amounts and preservation of this balance of microorganisms in the next six months.