Sweat metabolomics before and after intravenous antibiotics for pulmonary exacerbation in people with cystic fibrosis

Pulmonary exacerbations are common events in cystic fibrosis and have a profound impact on quality of life, morbidity, and mortality. Pulmonary exacerbation outcomes remain poor and a significant proportion of patients fail to recover their baseline lung function despite receiving aggressive treatment with intravenous antibiotics. This focused review provides an update on some of the recent advances that have taken place in our understanding of the epidemiology, pathophysiology, diagnosis, and management of pulmonary exacerbations in cystic fibrosis as well as direction for future study.

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The role of respiratory viruses in adult patients with cystic fibrosis receiving intravenous antibiotics for a pulmonary exacerbation

Journal of Cystic Fibrosis ◽

10.1016/j.jcf.2013.06.004 ◽

2014 ◽

Vol 13 (1) ◽

pp. 49-55 ◽

Cited By ~ 37

Author(s):

C. Etherington ◽

R. Naseer ◽

S.P. Conway ◽

P. Whitaker ◽

M. Denton ◽

...

Keyword(s):

Cystic Fibrosis ◽

Respiratory Viruses ◽

Adult Patients ◽

Pulmonary Exacerbation ◽

Intravenous Antibiotics

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195 Intravenous antibiotics effects on spirometrics parameters of Cystic Fibrosis (CF) patients with acute pulmonary exacerbation infected with Pseudomonas aeruginosa

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(06)80177-3 ◽

2006 ◽

Vol 5 ◽

pp. S45

Author(s):

C.I.S. Santos ◽

M.A.G.O. Ribeiro ◽

S.R.M. Paula ◽

R.T. Mendes ◽

A.E Ribeiro ◽

...

Keyword(s):

Cystic Fibrosis ◽

Pseudomonas Aeruginosa ◽

Pulmonary Exacerbation ◽

Intravenous Antibiotics

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136 The degree of change in FEV1 and FVC after 2 weeks of intravenous antibiotics for severe pulmonary exacerbation in adult patients with cystic fibrosis

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(07)60122-2 ◽

2007 ◽

Vol 6 ◽

pp. S33

Author(s):

N.A. Jarad ◽

C. Stanley ◽

W. Gunasekera

Keyword(s):

Cystic Fibrosis ◽

Adult Patients ◽

Pulmonary Exacerbation ◽

Intravenous Antibiotics

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Pyrosequencing reveals transient cystic fibrosis lung microbiome changes with intravenous antibiotics

European Respiratory Journal ◽

10.1183/09031936.00203013 ◽

2014 ◽

Vol 44 (4) ◽

pp. 922-930 ◽

Cited By ~ 49

Author(s):

Daniel J. Smith ◽

Alison C. Badrick ◽

Martha Zakrzewski ◽

Lutz Krause ◽

Scott C. Bell ◽

...

Keyword(s):

Cystic Fibrosis ◽

Bacterial Community ◽

Microbial Diversity ◽

Community Composition ◽

Relative Abundance ◽

Bacterial Community Composition ◽

Molecular Techniques ◽

Pulmonary Exacerbation ◽

Intravenous Antibiotics ◽

The Impact

Chronic airway infection in adults with cystic fibrosis (CF) is polymicrobial and the impact of intravenous antibiotics on the bacterial community composition is poorly understood. We employed culture-independent molecular techniques to explore the early effects of i.v. antibiotics on the CF airway microbiome.DNA was extracted from sputum samples collected from adult subjects with CF at three time-points (before starting treatment, and at day 3 and day 8–10 of i.v. antibiotics) during treatment of an infective pulmonary exacerbation. Microbial community profiles were derived through analysis of bacterial-derived 16S ribosomal RNA by pyrosequencing and changes over time were compared.59 sputum samples were collected during 24 pulmonary exacerbations from 23 subjects. Between treatment onset and day 3 there was a significant reduction in the relative abundance of Pseudomonas and increased microbial diversity. By day 8–10, bacterial community composition was similar to pre-treatment. Changes in community composition did not predict improvements in lung function.The relative abundance of Pseudomonas falls rapidly in subjects with CF receiving i.v. antibiotic treatment for a pulmonary exacerbation and is accompanied by an increase in overall microbial diversity. However, this effect is not maintained beyond the first week of treatment.

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