Journal
EXPERT REVIEW OF RESPIRATORY MEDICINE
Volume 9, Issue 1, Pages 73-88Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/17476348.2015.995640
Keywords
biofilms; combined treatment; cystic fibrosis; epidemic strains; hypermutation; infection control; multidrug resistance; PK; PD parameters; Pseudomonas aeruginosa; sequential treatment
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Funding
- Ministerio de Economia y Competitividad of Spain
- Instituto de Salud Carlos III, through the Spanish Network for the Research in Infectious Diseases [RD06/0008, RD12/0015]
- Direccio General d'Universitats, Recerca i Transferencia del Coneixement del Govern de les Illes Balears
- Jannsen Cilag
- Cubist Pharmaceuticals
- Gilead Sciences
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Chronic respiratory infection is the main cause of morbidity and mortality in cystic fibrosis (CF) patients. One of the hallmarks of these infections, led by the opportunistic pathogen Pseudomonas aeruginosa, is their long-term (lifelong) persistence despite intensive antimicrobial therapy. Antimicrobial resistance in CF is indeed a multifactorial problem, which includes physiological changes, represented by the transition from the planktonic to the biofilm mode of growth and the acquisition of multiple (antibiotic resistance) adaptive mutations catalyzed by frequent mutator phenotypes. Emerging multidrug-resistant CF pathogens, transmissible epidemic strains and transferable genetic elements (such as those encoding class B carbapenemases) also significantly contribute to this concerning scenario. Strategies directed to combat biofilm growth, prevent the emergence of mutational resistance, promote the development of novel antimicrobial agents against multidrug-resistant strains and implement strict infection control measures are thus needed.
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