Laboratory of Pharmaceutical Microbiology, Ghent University, Ghent, Belgium.
Dept of Respiratory Medicine, Cystic Fibrosis Reference Centre, Ghent University Hospital, Ghent, Belgium.
Eur Respir Rev. 2021 Sep 15;30(161). doi: 10.1183/16000617.0055-2021. Print 2021 Sep 30.
Chronic airway colonisation by , a hallmark of cystic fibrosis (CF) lung disease, is associated with increased morbidity and mortality and despite aggressive antibiotic treatment, is able to persist in CF airways. antibiotic susceptibility assays are poor predictors of antibiotic efficacy to treat respiratory tract infections in the CF patient population and the selection of the antibiotic(s) is often made on an empirical base. In the current review, we discuss the factors that are responsible for the discrepancies between antibiotic activity and clinical efficacy We describe how the CF lung microenvironment, shaped by host factors (such as iron, mucus, immune mediators and oxygen availability) and the microbiota, influences antibiotic activity and varies widely between patients. A better understanding of the CF microenvironment and population diversity may thus help improve antibiotic susceptibility testing and clinical decision making, in turn increasing the success rate of antibiotic treatment.
定植于气道是囊性纤维化（CF）肺部疾病的标志，与发病率和死亡率增加相关，尽管进行了积极的抗生素治疗，但仍能在 CF 气道中持续存在。抗生素药敏试验不能很好地预测抗生素治疗 CF 患者呼吸道感染的疗效，抗生素的选择通常基于经验。在本综述中，我们讨论了导致抗生素活性与临床疗效之间差异的因素。我们描述了 CF 肺部微环境如何受到宿主因素（如铁、黏液、免疫介质和氧气供应）和微生物群的影响，从而影响抗生素活性，并在患者之间存在广泛差异。因此，更好地了解 CF 微环境和人群多样性可能有助于改善抗生素药敏试验和临床决策，从而提高抗生素治疗的成功率。
