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The problems of antibiotic resistance in cystic fibrosis and solutions

Carla López-Causapé1, Estrella Rojo-Molinero, María D Macià

  • 1Servicio de Microbiología and Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdISPa), Ctra. Valldemossa 79, 07010 Palma de Mallorca, Spain.

Expert Review of Respiratory Medicine
|December 27, 2014
PubMed

Insights

Chronic respiratory infections in cystic fibrosis (CF) patients, often caused by Pseudomonas aeruginosa, persist due to antimicrobial resistance. Strategies are needed to combat biofilm, prevent mutations, and develop new treatments for these challenging infections.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pulmonology

Background:

  • Chronic respiratory infections are a primary cause of illness and death in cystic fibrosis (CF) patients.
  • Pseudomonas aeruginosa infections in CF are lifelong and difficult to treat with antibiotics.
  • Antimicrobial resistance in CF is complex, involving biofilm formation and adaptive mutations.

Purpose of the Study:

  • To review the challenges of chronic respiratory infections and antimicrobial resistance in cystic fibrosis.
  • To highlight the role of Pseudomonas aeruginosa and multidrug-resistant pathogens.
  • To discuss the need for novel strategies to combat these infections.

Main Methods:

  • Literature review of antimicrobial resistance mechanisms in CF.
  • Analysis of Pseudomonas aeruginosa's role and biofilm formation.
  • Examination of emerging multidrug-resistant strains and genetic elements.

Main Results:

  • Pseudomonas aeruginosa exhibits long-term persistence in CF patients despite treatment.
  • Antimicrobial resistance is driven by biofilm growth, adaptive mutations, and mutator phenotypes.
  • Transmissible epidemic strains and carbapenemase-encoding elements exacerbate the problem.

Conclusions:

  • Effective strategies must address biofilm growth and prevent resistance emergence.
  • Development of new antimicrobial agents against multidrug-resistant strains is crucial.
  • Strict infection control measures are essential for managing CF pathogens.
Keywords:
PK/PD parametersPseudomonas aeruginosabiofilmscombined treatmentcystic fibrosisepidemic strainshypermutationinfection controlmultidrug resistancesequential treatment

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