SlideShare ist ein Scribd-Unternehmen logo
1 von 29
Bugs, biofilms and resistance in Cystic Fibrosis Davies et al Respiratory Care May 2009 Infectious Disease Journal Club 20 August 2009 Dr Preneshni R Naicker
Background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why the propensity for bacterial infection? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Break down intercellular tight juctions Slow ciliary beat functions Siderophores  Inhibits phagocytosis Suppresses cell-mediated immunity Exotoxin A Cleave Immunoglobulins, complement components and cytokines Elastase Protease
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Biofilm  production
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Infection with other organisms
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Virulence factors of Burkholderia cepacia complex
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevention ,[object Object],[object Object],[object Object]
Treatment – basic principles ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Eradication of early Pseudomonas infection in Cystic Fibrosis TWR Lee Chronic Respiratory Disease Journal, May 2009
Introduction ,[object Object],[object Object],[object Object]
Definitions
 
How to detect P.aeruginosa in CF pts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is the evidence that early eradication is effective? ,[object Object],[object Object],[object Object]
What agents should be used in eradication regimes?
[object Object],[object Object],[object Object],[object Object]
Any adverse effects of early eradication? ,[object Object],[object Object],[object Object],[object Object]
Practical aspects ,[object Object],[object Object],[object Object],[object Object]
Thank you

Weitere ähnliche Inhalte

Was ist angesagt?

Cystic Fibrosis
Cystic FibrosisCystic Fibrosis
Cystic Fibrosisjmsfourpg
 
#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapy
#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapy#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapy
#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapyKyriaki Andronikou
 
The Truth about Cystic Fibrosis
The Truth about Cystic FibrosisThe Truth about Cystic Fibrosis
The Truth about Cystic Fibrosisamypace
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosisjoeyprince
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosissangita8
 
Cystic fibrosis done by my friend LORD JESUS
Cystic fibrosis done by my friend LORD JESUSCystic fibrosis done by my friend LORD JESUS
Cystic fibrosis done by my friend LORD JESUScaroline karunya
 
RESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSISRESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSISULVAN OZAD
 
gene therapy for cistic fibrosis
gene therapy for cistic fibrosisgene therapy for cistic fibrosis
gene therapy for cistic fibrosisAnjali Patil
 

Was ist angesagt? (20)

Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
Cystic Fibrosis
Cystic FibrosisCystic Fibrosis
Cystic Fibrosis
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
Cysticfibrosis
CysticfibrosisCysticfibrosis
Cysticfibrosis
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
CYSTIC FIBROSIS
CYSTIC FIBROSISCYSTIC FIBROSIS
CYSTIC FIBROSIS
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapy
#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapy#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapy
#scichallenge2017 #scienceincypriotschools Cystic Fibrosis and gene therapy
 
cystic fibrosis
cystic fibrosiscystic fibrosis
cystic fibrosis
 
CYSTIC FIBROSIS
CYSTIC FIBROSISCYSTIC FIBROSIS
CYSTIC FIBROSIS
 
The Truth about Cystic Fibrosis
The Truth about Cystic FibrosisThe Truth about Cystic Fibrosis
The Truth about Cystic Fibrosis
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
Cystic fibrosis
Cystic fibrosisCystic fibrosis
Cystic fibrosis
 
Cystic fibrosis done by my friend LORD JESUS
Cystic fibrosis done by my friend LORD JESUSCystic fibrosis done by my friend LORD JESUS
Cystic fibrosis done by my friend LORD JESUS
 
RESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSISRESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSIS
 
Cystic fibrosis anaesthesia presentation
Cystic fibrosis anaesthesia presentation Cystic fibrosis anaesthesia presentation
Cystic fibrosis anaesthesia presentation
 
gene therapy for cistic fibrosis
gene therapy for cistic fibrosisgene therapy for cistic fibrosis
gene therapy for cistic fibrosis
 

Andere mochten auch (7)

SCK.urcposter2
SCK.urcposter2SCK.urcposter2
SCK.urcposter2
 
UROP Poster
UROP PosterUROP Poster
UROP Poster
 
Seminar burkholderia 1
Seminar burkholderia 1Seminar burkholderia 1
Seminar burkholderia 1
 
Isoprenoids
IsoprenoidsIsoprenoids
Isoprenoids
 
Biofilm
BiofilmBiofilm
Biofilm
 
Confocal microscopy
Confocal microscopyConfocal microscopy
Confocal microscopy
 
Confocal microscopy
Confocal microscopyConfocal microscopy
Confocal microscopy
 

Ähnlich wie Cystic Fibrosis Infections

Community acquired pneumonia
Community acquired pneumoniaCommunity acquired pneumonia
Community acquired pneumoniaAdel Hamada
 
Management of systemic fungal infection in newborn
Management of systemic fungal infection in newbornManagement of systemic fungal infection in newborn
Management of systemic fungal infection in newbornRizwan Naqishbandi
 
Antibiotic in ED
Antibiotic in EDAntibiotic in ED
Antibiotic in EDEM OMSB
 
QUINOLONES IN CARTIs
QUINOLONES IN CARTIsQUINOLONES IN CARTIs
QUINOLONES IN CARTIsJohnScreen
 
ventilator-associated pneumonia.ppt
ventilator-associated pneumonia.pptventilator-associated pneumonia.ppt
ventilator-associated pneumonia.pptssuser0622881
 
Invasive candidiasis the hidden cause of sepsis
Invasive candidiasis the hidden cause of sepsisInvasive candidiasis the hidden cause of sepsis
Invasive candidiasis the hidden cause of sepsisKhaled Taema
 
18. antibiotic use in the ic ul
18. antibiotic use in the ic ul18. antibiotic use in the ic ul
18. antibiotic use in the ic ulYerragunta Tirumal
 
Managing MDR/XDR Gram Negative infections in ICU
Managing MDR/XDR Gram Negative infections in ICUManaging MDR/XDR Gram Negative infections in ICU
Managing MDR/XDR Gram Negative infections in ICUVitrag Shah
 
CAP 2010 Guidelines
CAP 2010 GuidelinesCAP 2010 Guidelines
CAP 2010 Guidelinescap_0009
 
Viral diseases in ruminant
Viral diseases in ruminantViral diseases in ruminant
Viral diseases in ruminanthamed attia
 
Antibiotic resistance dr sachin
Antibiotic resistance dr sachinAntibiotic resistance dr sachin
Antibiotic resistance dr sachinSachin Verma
 
Relapsing coagulase negative staphylococcus peritonitis
Relapsing coagulase negative staphylococcus peritonitis Relapsing coagulase negative staphylococcus peritonitis
Relapsing coagulase negative staphylococcus peritonitis Ahmed Mostafa Taha Borham
 
Invasive fungal infection in icu
Invasive fungal infection in icuInvasive fungal infection in icu
Invasive fungal infection in icupulmonary medicine
 

Ähnlich wie Cystic Fibrosis Infections (20)

Community acquired pneumonia
Community acquired pneumoniaCommunity acquired pneumonia
Community acquired pneumonia
 
Management of systemic fungal infection in newborn
Management of systemic fungal infection in newbornManagement of systemic fungal infection in newborn
Management of systemic fungal infection in newborn
 
Antibiotic in ED
Antibiotic in EDAntibiotic in ED
Antibiotic in ED
 
HAP VAP CHALLENGES
HAP VAP CHALLENGESHAP VAP CHALLENGES
HAP VAP CHALLENGES
 
QUINOLONES IN CARTIs
QUINOLONES IN CARTIsQUINOLONES IN CARTIs
QUINOLONES IN CARTIs
 
Dprajani
DprajaniDprajani
Dprajani
 
D p ppp
D p pppD p ppp
D p ppp
 
ventilator-associated pneumonia.ppt
ventilator-associated pneumonia.pptventilator-associated pneumonia.ppt
ventilator-associated pneumonia.ppt
 
Invasive candidiasis the hidden cause of sepsis
Invasive candidiasis the hidden cause of sepsisInvasive candidiasis the hidden cause of sepsis
Invasive candidiasis the hidden cause of sepsis
 
18. antibiotic use in the ic ul
18. antibiotic use in the ic ul18. antibiotic use in the ic ul
18. antibiotic use in the ic ul
 
Managing MDR/XDR Gram Negative infections in ICU
Managing MDR/XDR Gram Negative infections in ICUManaging MDR/XDR Gram Negative infections in ICU
Managing MDR/XDR Gram Negative infections in ICU
 
CAP 2010 Guidelines
CAP 2010 GuidelinesCAP 2010 Guidelines
CAP 2010 Guidelines
 
Antibiotic choices
Antibiotic choicesAntibiotic choices
Antibiotic choices
 
Viral diseases in ruminant
Viral diseases in ruminantViral diseases in ruminant
Viral diseases in ruminant
 
Tuberculosis
TuberculosisTuberculosis
Tuberculosis
 
Tuberculosis
TuberculosisTuberculosis
Tuberculosis
 
Antibiotics
AntibioticsAntibiotics
Antibiotics
 
Antibiotic resistance dr sachin
Antibiotic resistance dr sachinAntibiotic resistance dr sachin
Antibiotic resistance dr sachin
 
Relapsing coagulase negative staphylococcus peritonitis
Relapsing coagulase negative staphylococcus peritonitis Relapsing coagulase negative staphylococcus peritonitis
Relapsing coagulase negative staphylococcus peritonitis
 
Invasive fungal infection in icu
Invasive fungal infection in icuInvasive fungal infection in icu
Invasive fungal infection in icu
 

Mehr von Prenesh

Urinary LAM
Urinary LAMUrinary LAM
Urinary LAMPrenesh
 
Virology Journal Club
Virology Journal ClubVirology Journal Club
Virology Journal ClubPrenesh
 
Arenaviruses
ArenavirusesArenaviruses
ArenavirusesPrenesh
 
Effect Of Vancomycin And Teicoplanin Alone Or In
Effect Of Vancomycin And Teicoplanin Alone Or InEffect Of Vancomycin And Teicoplanin Alone Or In
Effect Of Vancomycin And Teicoplanin Alone Or InPrenesh
 
Literature Reviews
Literature ReviewsLiterature Reviews
Literature ReviewsPrenesh
 

Mehr von Prenesh (7)

Urinary LAM
Urinary LAMUrinary LAM
Urinary LAM
 
Polio
PolioPolio
Polio
 
Virology Journal Club
Virology Journal ClubVirology Journal Club
Virology Journal Club
 
Arenaviruses
ArenavirusesArenaviruses
Arenaviruses
 
Amp C
Amp CAmp C
Amp C
 
Effect Of Vancomycin And Teicoplanin Alone Or In
Effect Of Vancomycin And Teicoplanin Alone Or InEffect Of Vancomycin And Teicoplanin Alone Or In
Effect Of Vancomycin And Teicoplanin Alone Or In
 
Literature Reviews
Literature ReviewsLiterature Reviews
Literature Reviews
 

Kürzlich hochgeladen

Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Bangalore Call Girls Hebbal Kempapura Number 7001035870 Meetin With Bangalor...
Bangalore Call Girls Hebbal Kempapura Number 7001035870  Meetin With Bangalor...Bangalore Call Girls Hebbal Kempapura Number 7001035870  Meetin With Bangalor...
Bangalore Call Girls Hebbal Kempapura Number 7001035870 Meetin With Bangalor...narwatsonia7
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...narwatsonia7
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...narwatsonia7
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on DeliveryCall Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Deliverynehamumbai
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableNehru place Escorts
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...narwatsonia7
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
Call Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 

Kürzlich hochgeladen (20)

Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Bangalore Call Girls Hebbal Kempapura Number 7001035870 Meetin With Bangalor...
Bangalore Call Girls Hebbal Kempapura Number 7001035870  Meetin With Bangalor...Bangalore Call Girls Hebbal Kempapura Number 7001035870  Meetin With Bangalor...
Bangalore Call Girls Hebbal Kempapura Number 7001035870 Meetin With Bangalor...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 8250192130 ⟟ Call Me For Gen...
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
 
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCREscort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on DeliveryCall Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
Call Girls Colaba Mumbai ❤️ 9920874524 👈 Cash on Delivery
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
 
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...Bangalore Call Girls Nelamangala Number 7001035870  Meetin With Bangalore Esc...
Bangalore Call Girls Nelamangala Number 7001035870 Meetin With Bangalore Esc...
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
 
Call Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Darjeeling Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
 

Cystic Fibrosis Infections