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The polymicrobial nature of airway infections in cystic fibrosis: Cangene Gold Medal Lecture

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Abstract:

Microbial communities characterize the airways of cystic fibrosis (CF) patients. Members of these diverse and dynamic communities can be thought of as pathogens, benign commensals, or synergens - organisms not considered pathogens in the traditional sense but with the capacity to alter the pathogenesis of the community through microbe-microbe or polymicrobe-host interactions. Very few bacterial pathogens have been implicated as clinically relevant in CF; however, the CF airway microbiome can be a reservoir of previously unrecognized but clinically relevant organisms. A combination of culture-dependent and culture-independent approaches provides a more comprehensive perspective of CF microbiology than either approach alone. Here we review these concepts, highlight the future challenges for CF microbiology, and discuss the implications for the management of CF airway infections. We suggest that the success of treatment interventions for chronic CF lung disease will rely on the context of the microbes within microbial communities. The microbiology of CF airways may serve as a model to investigate the emergent properties of other clinically relevant microbial communities in the human body.

Les communautés microbiennes caractérisent les voies respiratoires des patients atteints de fibrose kystique (FK). Les membres de ces communautés diverses et dynamiques peuvent être vus comme pathogènes, commensaux bénins ou synergènes - des organismes considérés comme non pathogènes au sens traditionnel du terme mais qui ont la capacité de modifier la pathogenèse d’une communauté à travers des interactions microbe-microbe ou polymicrobe-hôte. Très peu de pathogènes bactériens ont été considérés cliniquement pertinents dans la FK. Cependant, le microbiome des voies respiratoires des patients atteints de FK peut constituer un réservoir d’organismes cliniquement pertinents mais non reconnus auparavant. Une combinaison d’approches dépendantes et indépendantes de la culture ouvre une perspective plus complète de la microbiologie de la FK que si chaque approche est prise individuellement. Nous passons ici en revue ces concepts, soulignons les défis futurs de la microbiologie de la FK et discutons des implications de la gestion des infections respiratoires dans la FK. Nous suggérons que le succès des traitements des maladies pulmonaires chroniques dans la FK reposera sur le contexte dans lequel les microbes se situeront au sein d’une communauté microbienne. La microbiologie des voies respiratoires dans la FK peut servir de modèle afin d’étudier les propriétés émergentes d’autres communautés microbiennes cliniquement pertinentes du corps humain.

Document Type: Research Article

Publication date: 2011-02-01

More about this publication?
  • Published since 1954, this monthly journal contains new research in the field of microbiology including applied microbiology and biotechnology; microbial structure and function; fungi and other eucaryotic protists; infection and immunity; microbial ecology; physiology, metabolism and enzymology; and virology, genetics, and molecular biology. It also publishes review articles and notes on an occasional basis, contributed by recognized scientists worldwide.
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