title: The polymicrobial nature of airway infections in cystic fibrosis: Cangene Gold Medal Lecture.
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.
authors.affiliation: Department of Microbiology and Infectious Diseases, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada. christopher.sibley@gmail.com
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Sibley
authors.forename: Michael G
authors.initials: MG
authors.lastname: Surette
mesh_terms: D000818:Animals; D001419:Bacteria / Q000235:genetics* / Q000254:growth & development; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology*; D004195:Disease Models, Animal; D004331:Drosophila melanogaster / Q000382:microbiology; D006801:Humans; D054892:Metagenome; D012137:Respiratory System / Q000382:microbiology / Q000473:pathology; D012141:Respiratory Tract Infections / Q000150:complications / Q000382:microbiology*