Høiby Niels, Bjarnsholt Thomas, Moser Claus, Jensen Peter Østrup, Kolpen Mette, Qvist Tavs, Aanaes Kasper, Pressler Tanja, Skov Marianne, Ciofu Oana
Department of Clinical Microbiology, University of Copenhagen, Copenhagen, Denmark.
Costerton Biofilm Center, Institute for Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
APMIS. 2017 Apr;125(4):339-343. doi: 10.1111/apm.12689.
Chronic Pseudomonas aeruginosa biofilm lung infection in cystic fibrosis patients is the best described biofilm infection in medicine. The initial focus can be the paranasal sinuses and then follows repeated colonization and infection of the lungs by aspiration. The matrix of the biofilms is dominated by alginate and the pathogenesis of tissue damage is immune complex-mediated chronic inflammation dominated by polymorphonuclear leukocytes and their products (DNA, oxygen radicals and proteases). The P. aeruginosa biofilm infection can be diagnosed by microscopy of lung tissue, sputum and mucus from the paranasal sinuses, where aggregates of the bacteria are found surrounded by the abundant alginate matrix. Specific PNA-FISH probes can be used to identify P. aeruginosa and other pathogens in situ in the biofilms. Growth of mucoid colonies from the locations mentioned above is also diagnostic for biofilm infection. Rise of specific anti-P. aeruginosa antibodies is likewise diagnostic, IgG in serum in case of lung infection, sIgA in saliva or nasal secretions in case of paranasal sinus infection. Similar approaches have been developed to diagnose chronic biofilm infections in cystic fibrosis caused by other pathogens e.g., Stenotrophomonas, Burkholderia multivorans, Achromobacter xylosoxidans and Mycobacterium abscessus complex.
囊性纤维化患者的慢性铜绿假单胞菌生物被膜肺部感染是医学上描述最为详尽的生物被膜感染。最初的感染部位可能是鼻窦，随后通过误吸导致肺部反复定植和感染。生物被膜的基质主要由藻酸盐组成，组织损伤的发病机制是由多形核白细胞及其产物（DNA、氧自由基和蛋白酶）主导的免疫复合物介导的慢性炎症。铜绿假单胞菌生物被膜感染可通过对肺组织、痰液和鼻窦黏液进行显微镜检查来诊断，在这些样本中可发现细菌聚集体被丰富的藻酸盐基质所包围。特异性肽核酸荧光原位杂交（PNA-FISH）探针可用于在生物被膜中原位鉴定铜绿假单胞菌和其他病原体。从上述部位培养出黏液样菌落也可诊断为生物被膜感染。特异性抗铜绿假单胞菌抗体水平升高同样具有诊断意义，肺部感染时血清中的IgG升高，鼻窦感染时唾液或鼻腔分泌物中的分泌型IgA升高。目前已开发出类似的方法来诊断由其他病原体引起的囊性纤维化慢性生物被膜感染，例如嗜麦芽窄食单胞菌、多食伯克霍尔德菌、木糖氧化无色杆菌和脓肿分枝杆菌复合体。
