Epidemiology, Biology, and Impact of Clonal Pseudomonas aeruginosa Infections in Cystic Fibrosis

Abstract

SUMMARYChronic lower airway infection with is a major contributor to morbidity and mortality in individuals suffering from the genetic disease cystic fibrosis (CF). Whereas it was long presumed that each patient independently acquired unique strains of present in their living environment, multiple studies have since demonstrated that shared strains of exist among individuals with CF. Many of these shared strains, often referred to as clonal or epidemic strains, can be transmitted from one CF individual to another, potentially reaching epidemic status. Numerous epidemic strains have been described from different parts of the world and are often associated with an antibiotic-resistant phenotype. Importantly, infection with these strains often portends a worse prognosis than for infection with nonclonal strains, including an increased pulmonary exacerbation rate, exaggerated lung function decline, and progression to end-stage lung disease. This review describes the global epidemiology of clonal strains in CF and summarizes the current literature regarding the underlying biology and clinical impact of globally important CF clones. Mechanisms associated with patient-to-patient transmission are discussed, and best-evidence practices to prevent infections are highlighted. Preventing new infections with epidemic strains is of paramount importance in mitigating CF disease progression.

Epidemiology of E. coli in Cystic Fibrosis Airways Demonstrates the Capacity for Persistent Infection but Not Patient-Patient Transmission

“…(Lieberman et al, 2011), P. aeruginosa (Denton et al, 2002;Marvig et al, 2015), and Mycobacteroides (formerly Mycobacterium) abscessus complex (Bryant et al, 2013). Many of these comprise epidemic strains, most notably P. aeruginosa, which are shared among many CF patients and often represent CF-specific lineages (Parkins et al, 2018). However, studies to date have neither investigated the potential of E. coli, as a nonclassical CF pathogen, for patient-to-patient transmission, nor for the existence of epidemic lineages -an important consideration given its evolved role as a human pathogen.…”

The Pseudomonas aeruginosa Population among Cystic Fibrosis Patients in Quebec, Canada: a Disease Hot Spot without Known Epidemic Isolates

“…Canadian molecular epidemiology of P. aeruginosa may benefit from similar nationwide data from the United States. But, as mentioned in a recent review (16), there is a void to be filled in the literature in this regard.…”

ThiL is a valid antibacterial target that is essential for both thiamine biosynthesis and salvage pathway inPseudomonas aeruginosa

“…Pseudomonas aeruginosa is a gramnegative opportunistic pathogen associated with a wide range of acute and chronic infections of various body sites, including the urinary tract, skin, and respiratory tract (1). Patients with compromised immune defenses due to underlying diseases such as cancer or HIV infection or with severe burns, cystic fibrosis, bronchiectasis, or chronic obstructive pulmonary disease are particularly susceptible to P. aeruginosa infection (2)(3)(4)(5)(6)(7). The mainstay of treatment for P. aeruginosa infection is antibiotics.…”