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Current and future therapies for Pseudomonas aeruginosa infection in patients with cystic fibrosis

Current and future therapies for Pseudomonas aeruginosa infection in patients with cystic fibrosis
Current and future therapies for Pseudomonas aeruginosa infection in patients with cystic fibrosis

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, β-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.

Adaptation, Antibiotic resistance, Diagnosis, Novel therapies, Pseudomonas aeruginosa
0378-1097
1-9
Smith, Wynne D.
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Bardin, Emmanuelle
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Cameron, Loren
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Edmondson, Claire L.
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Farrant, Katie V.
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Martin, Isaac
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Murphy, Ronan A.
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Soren, Odel
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Turnbull, Andrew R.
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Wierre-Gore, Natasha
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Alton, Eric W.
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Bundy, Jacob G.
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Bush, Andrew
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Connett, Gary J.
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Faust, Saul N.
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Filloux, Alain
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Freemont, Paul S.
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Jones, Andrew L.
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Takats, Zoltan
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Webb, Jeremy S.
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Williams, Huw D.
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Davies, Jane C.
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Smith, Wynne D.
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Bardin, Emmanuelle
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Cameron, Loren
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Edmondson, Claire L.
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Farrant, Katie V.
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Martin, Isaac
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Murphy, Ronan A.
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Soren, Odel
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Turnbull, Andrew R.
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Wierre-Gore, Natasha
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Alton, Eric W.
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Bundy, Jacob G.
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Bush, Andrew
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Connett, Gary J.
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Faust, Saul N.
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Filloux, Alain
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Freemont, Paul S.
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Jones, Andrew L.
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Takats, Zoltan
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Webb, Jeremy S.
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Williams, Huw D.
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Davies, Jane C.
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Smith, Wynne D., Bardin, Emmanuelle, Cameron, Loren, Edmondson, Claire L., Farrant, Katie V., Martin, Isaac, Murphy, Ronan A., Soren, Odel, Turnbull, Andrew R., Wierre-Gore, Natasha, Alton, Eric W., Bundy, Jacob G., Bush, Andrew, Connett, Gary J., Faust, Saul N., Filloux, Alain, Freemont, Paul S., Jones, Andrew L., Takats, Zoltan, Webb, Jeremy S., Williams, Huw D. and Davies, Jane C. (2017) Current and future therapies for Pseudomonas aeruginosa infection in patients with cystic fibrosis. FEMS Microbiology Letters, 364 (14), 1-9, [fnx121]. (doi:10.1093/femsle/fnx121).

Record type: Review

Abstract

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, β-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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More information

Accepted/In Press date: 12 June 2017
e-pub ahead of print date: 15 June 2017
Keywords: Adaptation, Antibiotic resistance, Diagnosis, Novel therapies, Pseudomonas aeruginosa

Identifiers

Local EPrints ID: 419581
URI: http://eprints.soton.ac.uk/id/eprint/419581
ISSN: 0378-1097
PURE UUID: 848b996a-d1c3-441c-9def-8c39e8ca15d4
ORCID for Gary J. Connett: ORCID iD orcid.org/0000-0003-1310-3239
ORCID for Saul N. Faust: ORCID iD orcid.org/0000-0003-3410-7642
ORCID for Jeremy S. Webb: ORCID iD orcid.org/0000-0003-2068-8589

Catalogue record

Date deposited: 13 Apr 2018 16:30
Last modified: 18 Mar 2024 03:46

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Contributors

Author: Wynne D. Smith
Author: Emmanuelle Bardin
Author: Loren Cameron
Author: Claire L. Edmondson
Author: Katie V. Farrant
Author: Isaac Martin
Author: Ronan A. Murphy
Author: Odel Soren
Author: Andrew R. Turnbull
Author: Natasha Wierre-Gore
Author: Eric W. Alton
Author: Jacob G. Bundy
Author: Andrew Bush
Author: Gary J. Connett ORCID iD
Author: Saul N. Faust ORCID iD
Author: Alain Filloux
Author: Paul S. Freemont
Author: Andrew L. Jones
Author: Zoltan Takats
Author: Jeremy S. Webb ORCID iD
Author: Huw D. Williams
Author: Jane C. Davies

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