Surette Michael G
1 Department of Medicine, Department of Biochemistry and Biomedical Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Ann Am Thorac Soc. 2014 Jan;11 Suppl 1:S61-5. doi: 10.1513/AnnalsATS.201306-159MG.
The chronic colonization of the lower airways by bacterial pathogens is the leading cause of morbidity and mortality in patients with cystic fibrosis (CF). Pseudomonas aeruginosa is the most common CF pathogen, followed by Staphylococcus aureus. Improvements in airway clearance and more effective treatment of the conventional CF pathogens has led to the emergence of new airway pathogens such as Stenotrophomonas maltophilia, Mycobacterium abscessus, and Achromobacter. More recently, it has become appreciated that the lower airways in patients with CF are colonized by a more complex polymicrobial community composed primarily of bacteria found in the upper respiratory tract. This includes obligate anaerobes, most commonly Prevotella. Expanded culturing methods and culture-independent molecular methods are being used to characterize the composition and dynamics of these polymicrobial communities in patients with CF. The contribution of the CF microbiome to airway disease is actively being investigated and will present new opportunities for disease management in CF. However, there remain many challenges that must be overcome if microbiome profiling is going to inform clinical practice.
细菌病原体在下呼吸道的慢性定植是囊性纤维化（CF）患者发病和死亡的主要原因。铜绿假单胞菌是最常见的CF病原体，其次是金黄色葡萄球菌。气道清除的改善以及对传统CF病原体更有效的治疗导致了新的气道病原体的出现，如嗜麦芽窄食单胞菌、脓肿分枝杆菌和无色杆菌。最近，人们逐渐认识到CF患者的下呼吸道被一个更复杂的多微生物群落定植，该群落主要由在上呼吸道中发现的细菌组成。这包括专性厌氧菌，最常见的是普雷沃菌属。扩展培养方法和不依赖培养的分子方法正被用于表征CF患者中这些多微生物群落的组成和动态。CF微生物群对气道疾病的作用正在积极研究中，这将为CF疾病管理带来新的机遇。然而，如果微生物群分析要为临床实践提供依据，仍有许多挑战必须克服。
