A polymicrobial perspective of pulmonary infections exposes an enigmatic pathogen in cystic fibrosis patients.
Lung disease is the leading cause of morbidity and mortality in cystic fibrosis (CF) patients. A modest number of bacterial pathogens have been correlated with pulmonary function decline; however, microbiological and molecular evidence suggests that CF airway infection is polymicrobial. To obtain a more complete assessment of the microbial community composition and dynamics, we undertook a longitudinal study by using culture-independent and microbiological approaches. In the process, we demonstrated that within complex and dynamic communities, the Streptococcus milleri group (SMG) can establish chronic pulmonary infections and at the onset of 39% of acute pulmonary exacerbations, SMG is the numerically dominant pathogen. We report the comprehensive polymicrobial community dynamics of a CF lung infection in a clinically relevant context. If a given organism, such as Pseudomonas aeruginosa, becomes resistant to antibiotic therapy, an alternative treatment avenue may mediate the desired clinical response by effectively managing the composition of the microbial community.
Sibley
Christopher D
CD
Department of Microbiology and Infectious Diseases, University of Calgary, Calgary, AB, Canada T2N 4N1.
Parkins
Michael D
MD
Rabin
Harvey R
HR
Duan
Kangmin
K
Norgaard
Jens C
JC
Surette
Michael G
MG
D000328:Adult; D001424:Bacterial Infections / Q000382:microbiology*; D003550:Cystic Fibrosis / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D013183:Sputum / Q000382:microbiology; D034365:Streptococcus constellatus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*