Rapid detection of Pseudomonas aeruginosa in people with cystic fibrosis

囊性纤维化（CF）是一种遗传性疾病，在英国影响着大约1.1万人，在全球影响着超过16万人。CF的影响之一是难以清除肺部粘液，这会导致呼吸困难，也会缩短寿命。CF患者致残和死亡的一个主要原因是肺部感染，因为他们的肺部不能有效地清除粘液和细菌。造成这种情况的最重要的细菌之一是铜绿假单胞菌（p.a.）。P.a.无处不在，但很少对肺部健康的人产生负面影响。在pwCF中，这种细菌可能是致命的，它是肺部健康下降的主要原因，影响人们的生活质量。大多数pwCF患者在很小的时候就开始肺部感染P.a.，一旦形成，就无法清除。在过去的十年里，英国的CF临床团队已经建立了一种策略，试图首先防止P.a.在肺部扎根，通过使用特定的抗生素来防止P.a.在肺部扎根（称为“根除疗法”）。然而，这些抗生素有副作用，不能一直服用。为了使根除治疗发挥作用，临床团队必须能够识别P.a.感染发生的时间，并尽快开始使用抗生素治疗pwCF。不幸的是，目前的临床实践并不理想，获得P.a.诊断样本的最简单方法是从pwCF肺部深处的咳嗽痰中提取样本。随着新的治疗方法改善CF症状，越来越多的pwCF无法咳痰，这意味着很难获得样本。所有这些都必须由临床团队完成，这意味着一次测试需要pwCF前往护理中心，由护士采集样本，然后由技术人员进行准备和测试，从而延迟诊断。我们正在开发一种新颖的测试，pwCF可以自己使用。它基于横向流动测试技术，这与COVID大流行期间使用的快速测试类似。这将使pwCF能够自由地在家中检测自己的P.a.感染，而不需要痰样本。这可以每年为NHS节省5800万英镑，为pwCF节省1200英镑，减少残疾并延长他们的寿命。

Cystic Fibrosis (CF) is a genetic disease that affects around 11,000 people in the UK, and over 160,000 globally. One of the effects of CF is difficulty in clearing lungs of mucus, which causes difficulties in breathing and can also shortens lifespan.A major cause of disability and death amongst people with CF (pwCF) is lung infections because their lungs cannot remove mucus and bacteria effectively. One of the most important bugs, that causes this is _Pseudomonas aeruginosa_ (P.a.). P.a. is present everywhere, but rarely has negative effects on people with healthy lungs. In pwCF, this bacterium can be deadly, and it is the leading cause of decline in lung health, compromising people's quality of life.Most pwCF first have P.a. infecting their lungs at a young age, and once it establishes, it cannot be removed. Over the past decade, CF clinical teams in the UK have built a strategy to try to prevent P.a. taking hold in the lungs in the first place, by administering specific antibiotics in order to prevent the P.a. from establishing itself in the lungs (called "eradication therapy"). However, these antibiotics have side-effects, and they cannot be taken all the time. For eradication therapy to work, clinical teams must be able to identify when P.a. infection has occurred and start treating pwCF with antibiotics as quickly as possible.Unfortunately, the current clinical practise is not ideal, the simplest way to get a sample for P.a. diagnosis is from coughed sputum from deep inside the lungs of pwCF. With new treatments improving CF symptoms, more pwCF are unable to cough sputum which means samples are hard to get hold of. All of this has to be done with a clinical team, meaning a single test requires the pwCF to travel to a care centre and have samples taken by a nurse and then prepared and tested by a technician delaying diagnosis. We are developing a novel test that pwCF can use themselves. It is based on lateral flow test technology, that is the similar to the rapid tests used during the COVID pandemic. This will enable pwCF to have the freedom to test themselves at home for P.a. infection and without needing a sputum sample. This could save the NHS up to £58 million and pwCF up to £1,200 per year reducing disability and increasing their lifespan.