Understanding persistent bacterial lung infections: clinical implications informed by the biology of the microbiota and biofilms.
Understanding persistent bacterial lung infections: clinical implications informed by the biology of the microbiota and biofilms.
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DOI：
10.1097/cpm.0000000000000108
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发表时间：
2016-03
影响因子：
--
通讯作者：
Williams BJ
中科院分区：
文献类型：
--
作者：
Pragman AA;Berger JP;Williams BJ
在慢性阻塞性肺疾病、囊性纤维化和支气管扩张中发现的感染有许多临床相似之处，其中最引人注目的是尽管使用抗生素，但细菌持续存在。这些感染在临床上已经使用通常在痰液样本上进行的基于培养的方法进行了描述，并且治疗已经针对以这种方式发现的细菌。不幸的是，基于这些培养物，对抗生素的临床反应通常是不可预测的，并且这些培养的生物体在疾病进展中的作用一直存在争议。在过去的20年里，用于描述细菌种群及其生长模式的技术发生了革命。这些技术揭示了这些持续性肺部感染比传统的，仍然广泛依赖的痰培养所描述的要复杂得多。更好地了解这些感染的发生和演变，以及更好的临床工具来描述它们，将大大改变患者的护理方式。虽然目前还没有更准确地描述这些感染的临床试验，但当前科学对这些感染的更好理解应该启发从业者如何护理患有这些疾病的患者。
The infections found in chronic obstructive pulmonary disease, cystic fibrosis, and bronchiectasis share a number of clinical similarities, the most striking of which is bacterial persistence despite the use of antibiotics. These infections have been clinically described using culture-based methods usually performed on sputum samples, and treatment has been directed towards the bacteria found in this manner. Unfortunately the clinical response to antibiotics is frequently not predictable based on these cultures, and the role of these cultured organisms in disease progression has been debated. The past 20 years have seen a revolution in the techniques used to describe bacterial populations and their growth patterns. These techniques have revealed these persistent lung infections are vastly more complicated than described by traditional, and still widely relied upon, sputum cultures. A better understanding of the initiation and evolution of these infections, and better clinical tools to describe them, will dramatically alter the way patients are cared for. While clinical tests to more accurately describe these infections are not yet available, the better appreciation of these infections afforded by current science should enlighten practitioners as to the care of their patients with these diseases.