An Overview of Infections in Cystic Fibrosis Airways and the Role of Environmental Conditions on Pseudomonas aeruginosa Biofilm Formation and Viability

Abstract

In this chapter, the authors review a major complication associated with cystic fibrosis (CF), problematic bacterial infections of the lungs. Infection by organisms such as Staphylococcus aureus, Burkholderia cepacia complex, and Pseudomonas aeruginosa (a major player in CF related infections) results in complications due to increased inflammation and production of virulence factors produced by the bacteria. In addition to these more canonical organisms associated with CF infection, emerging‐ bacterial species have been found in the CF, including anaerobes that have only within the past 5-10 years have been reported to exist in the lungs. P. aeruginosa has long been a cause of devastating infections, and is often seen as the“hallmark”organism associated with the disease. The authors describe the P. aeruginosa infection, including its conversion to a mucoid phenotype, as well as its ability to utilize the thicker airway surface layer associated with CF to grow in “mode two biofilms.” Finally, the authors discuss treatments for bacterial infections, and some of the new advances that offerhope for treatment of CF symptoms and infections by multi-drug resistant organisms. Among these new treatments is the application of acidified nitrite, a nonantibiotic treatment that has been found to be effective at killing nonmucoid and mucoid variants of P. aeruginosa.