ETHIOLOGY IN CYSTIC FIBROSIS PATIENTS

Abstract

Staphylococcus aureus was the first bacteria identified in cystic
fibrosis as a pathogen. Pseudomonas aeruginosa which was increasingly frequently isolated from cystic fibrosis patients in the 1960s and 1970s, it was initially not realised that it was a pathogen for cystic fibrosis patients and there were still reports until 1990 questioning its significance. A number of other rare bacteria have been detected clinically important for cystic fibrosis patients: Stenotrophomonas maltophilia (previously named P. maltophilia, Xantomonas maltophilia), Achromobacter xylosoxidans, Pandoraea spp. (including Pandoraea apista), Nontuberculous Mycobacteria spp. The features of microbiology diagnostics and result interpretation differ in the case of patients with cystic fibrosis and patients with other bacterial infections. Intermittent colonization should be discriminated from chronic infection either by frequently repeated cultures and/or by detecting an antibody response to the microbe. The morbidity in comprising inflammation, change on chest radiographs and the decrease of lung function and improvement during antibiotic therapy should be related to the presence of the microbe in the sputum and its disappearance or decrease after therapy. Qualified clinical microbiology laboratory service can identify the exact morphological type of pathogen and help to administrate the optimal antimicrobial treatment, that is a warranty of successful antimicrobial treatment of cystic fibrosis.