Reconciling Antimicrobial Susceptibility Testing and Clinical Response in Antimicrobial Treatment of Chronic Cystic Fibrosis Lung Infections

Valerie J. Waters*, Timothy J. Kidd, Rafael Canton, Miquel B. Ekkelenkamp, Helle Krogh Johansen, John J. Lipuma, Scott C. Bell, J. Stuart Elborn, Patrick A. Flume, Donald R. Vandevanter, Peter Gilligan, Wendy Bullington, Pierre Regis Burgel, Catherine Byrnes, Pavel Drevinek, Alison Holmes, Barbara Kahl, Holly Maples, Stacey Martiniano, Susanna McColleyAndrew Morris, Marianne Muhlebach, Michael Parkins, Felix Ratjen, Jason Roberts, Lisa Saiman, Anand Shah, Alan Smyth, Ranjani Somayaji, Giovanni Taccetti, Michael Tunney, Richard G Wunderink, Edith Zemanick

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

61 Scopus citations

Abstract

Median cystic fibrosis (CF) survival has increased dramatically over time due to several factors, including greater availability and use of antimicrobial therapies. During the progression of CF lung disease, however, the emergence of multidrug antimicrobial resistance can limit treatment effectiveness, threatening patient longevity. Current planktonic-based antimicrobial susceptibility testing lacks the ability to predict clinical response to antimicrobial treatment of chronic CF lung infections. There are numerous reasons for these limitations including bacterial phenotypic and genotypic diversity, polymicrobial interactions, and impaired antibiotic efficacy within the CF lung environment. The parallels to other chronic diseases such as non-CF bronchiectasis are discussed as well as research priorities for moving forward.

Original languageEnglish (US)
Pages (from-to)1812-1816
Number of pages5
JournalClinical Infectious Diseases
Volume69
Issue number10
DOIs
StatePublished - Nov 15 2019

Funding

Financial support. This work was supported by the European Cystic Fibrosis Society, Cystic Fibrosis Foundation, Cystic Fibrosis Trust, Cystic Fibrosis Canada, and Cystic Fibrosis Australia.

Keywords

  • antimicrobial susceptibility
  • cystic fibrosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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