Antimicrobial resistance in the respiratory microbiota of people with cystic fibrosis

Laura J. Sherrard, Michael M. Tunney, J. Stuart Elborn*

*Corresponding author for this work

Research output: Contribution to journalLiterature review

69 Citations (Scopus)

Abstract

Cystic fibrosis is characterised by chronic polymicrobial infection and inflammation in the airways of patients. Antibiotic treatment regimens, targeting recognised pathogens, have substantially contributed to increased life expectancy of patients with this disease. Although the emergence of antimicrobial resistance and selection of highly antibiotic-resistant bacterial strains is of major concern, the clinical relevance in cystic fibrosis is yet to be defined. Resistance has been identified in recognised cystic fibrosis pathogens and in other bacteria (eg, Prevotella and Streptococcus spp) detected in the airway microbiota, but their role in the pathophysiology of infection and inflammation in chronic lung disease is unclear. Increased antibiotic resistance in cystic fibrosis might be attributed to a range of complex factors including horizontal gene transfer, hypoxia, and biofilm formation. Strategies to manage antimicrobial resistance consist of new antibiotics or localised delivery of antimicrobial agents, iron sequestration, inhibition of quorum-sensing, and resistome analysis. Determination of the contributions of every bacterial species to lung health or disease in cystic fibrosis might also have an important role in the management of antibiotic resistance. 

Original languageEnglish
Pages (from-to)703-713
Number of pages11
JournalThe Lancet
Volume384
Issue number9944
Early online date21 Aug 2014
DOIs
Publication statusPublished - 23 Aug 2014

ASJC Scopus subject areas

  • Medicine(all)

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