Journal
FEMS MICROBIOLOGY LETTERS
Volume 364, Issue 14, Pages -Publisher
OXFORD UNIV PRESS
DOI: 10.1093/femsle/fnx121
Keywords
Pseudomonas aeruginosa; antibiotic resistance; novel therapies; adaptation; diagnosis
Categories
Funding
- Antabio
- CF Trust
- Vertex
- AlgiPharma
- Pharmaxis
- BBSRC [BB/R012415/1, BB/N002539/1, BB/L020858/1, BB/L007959/1, BB/M02735X/1] Funding Source: UKRI
- MRC [MR/J006874/1, MR/N023250/1] Funding Source: UKRI
- Asthma UK [MRC-Asthma UK Centre, MRC-AsthmaUKCentre] Funding Source: researchfish
- Biotechnology and Biological Sciences Research Council [BB/M02735X/1, BB/N002539/1, BB/L007959/1, BB/R012415/1, BB/L020858/1] Funding Source: researchfish
- Cystic Fibrosis Trust [SRC001] Funding Source: researchfish
- Medical Research Council [G1000758, MR/J006874/1, MR/N023250/1, G1000758B] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0616-10083] Funding Source: researchfish
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Pseudomonas aeruginosa opportunistically infects the airways of patients with cystic fibrosis and causes significant morbidity and mortality. Initial infection can often be eradicated though requires prompt detection and adequate treatment. Intermittent and then chronic infection occurs in the majority of patients. Better detection of P. aeruginosa infection using biomarkers may enable more successful eradication before chronic infection is established. In chronic infection P. aeruginosa adapts to avoid immune clearance and resist antibiotics via efflux pumps, beta-lactamase expression, reduced porins and switching to a biofilm lifestyle. The optimal treatment strategies for P. aeruginosa infection are still being established, and new antibiotic formulations such as liposomal amikacin, fosfomycin in combination with tobramycin and inhaled levofloxacin are being explored. Novel agents such as the alginate oligosaccharide OligoG, cysteamine, bacteriophage, nitric oxide, garlic oil and gallium may be useful as anti-pseudomonal strategies, and immunotherapy to prevent infection may have a role in the future. New treatments that target the primary defect in cystic fibrosis, recently licensed for use, have been associated with a fall in P. aeruginosa infection prevalence. Understanding the mechanisms for this could add further strategies for treating P. aeruginosa in future.
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