MICROBIOLOGY OF LUNG INFECTIONS IN CYSTIC FIBROSIS PATIENTS

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Abstract
Høiby, N. (Statens Seruminstitut, Department of Clinical Microbiology, Rigshospitalet and the Paediatric Department TG, Copenhagen, Denmark). Microbiology of lung infections in cystic fibrosis patients. Acta Paediatr Scand 1982; suppl 301: 33‐54. — Recurrent and chronic pulmonary infection is the major cause of morbidity and mortality in cystic fibrosis. Most of the exacerbations of the respiratory symptoms are due to bacterial infections, but infections caused by virus, chlamydia and mycoplasma may also contribute to the progression of the lung disease. A possible synergism between RS‐virus infection and chronic P. aeruginosa infection has been found. Allergic aspergillosis occurs in a few patients. Since the first description of the disease nearly 5O years ago, S. aureus has been recognized as a serious pathogen in CF, but due to efficient antibiotics, the importance of these bacteria to the mortality of CF patients has continued to decrease and is now minimal. During the last 20 years chronic P. aeruginosa infections caused by peculiar mucoid strains have replaced S. aureus as the main infectious problem in CF. The chronic P. aeruginosa infections are characterized by a pronounced antibody response, and the selected pressure of these antibodies in concert with other defense mechanisms in the CF lungs probably favour mucoid strains compared to non‐mucoid strains. Epidemiological typing of P. aeruginosa from CF patients and from their environments indicate that cross‐infection occurs between these patients; thus suitable prevention in hygiene measures should, therefore, be undertaken.