Abstract
The ultimate aim of any antimicrobial treatment is a better infection outcome for the patient. Here, we review the current state of treatment for bacterial infections in cystic fibrosis (CF) lung while also investigating potential new treatments being developed to see how they may change the dynamics of antimicrobial therapy. Treatment with antibiotics coupled with regular physical therapy has been shown to reduce exacerbations and may eradicate some strains. Therapies such as hypertonic saline and inhaled PulmozymeTM (DNase-I) improve mucus clearance, while modifier drugs, singly and more successfully in combination, re-open certain mutant forms of the cystic fibrosis transmembrane conductance regulator (CFTR) to enable ion passage. No current method, however, completely eradicates infection, mainly due to bacterial survival within biofilm aggregates. Lung transplants increase lifespan, but reinfection is a continuing problem. CFTR modifiers normalise ion transport for the affected mutations, but there is conflicting evidence on bacterial clearance. Emerging treatments combine antibiotics with novel compounds including quorum-sensing inhibitors, antioxidants, and enzymes, or with bacteriophages, aiming to disrupt the biofilm matrix and improve antibiotic access. Other treatments involve bacteriophages that target, infect and kill bacteria. These novel therapeutic approaches are showing good promise in vitro, and a few have made the leap to in vivo testing.
Highlights
The Cystic Fibrosis Lung EnvironmentCystic fibrosis (CF) is the most common life-threatening autosomal recessive genetic disease in the Caucasian population, with lower yet still significant incidence in other racial populations
The US Cystic Fibrosis Foundation data show that while the overall S. aureus prevalence peaked in adolescence and showed a modest decline in the 18–24-year age group, the prevalence of MRSA remained steady at ca. 30% between the ages of 11 and 34, highlighting the seriousness of this persistent infector in the US
The adolescent cystic fibrosis (CF) lung begins to show a greater, though still subdued, prevalence for four other species compared to the CF child lung: Stenotrophomonas maltophilia, Achromobacter xylosoxidans Burkholderia cepacia complex (BCC) and non-tuberculous Mycobacterium ((NTM) encompassing all Mycobacterial species other than Mycobacterium tuberculosis and Mycobacterium leprae
Summary
Cystic fibrosis (CF) is the most common life-threatening autosomal recessive genetic disease in the Caucasian population, with lower yet still significant incidence in other racial populations. In the CF lung, the airway surface liquid is acidified by loss of HCO 3−, and the gel layer is more viscous, similar to that of mucus [6]. This lack of mobility impairs the action of antimicrobial peptides such as the cationic host defence peptide LL37, which has been demonstrated be a potent inhibitor, inhibiting. Pseudomonas is more viscous,to similar to thatbiofilm of mucus [6] This lack of mobility impairs aeruginosa and Staphylococcus aureus biofilm formation in vitro [7,8]. Numerous disparate species, including anaerobes such as Streptoccoccus sp., Prevotella melaninogenica, and Veillonella dispar
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
