The following is a summary of “Impact of CFTR Modulation on Pseudomonas aeruginosa Infection in People With Cystic Fibrosis,” published in the March 2024 issue of Infectious Disease by Ledger, et al.
Cystic fibrosis transmembrane conductance regulator (CFTR) modulators show limited success in eradicating chronic Pseudomonas aeruginosa infections in people with cystic fibrosis (pwCF).
Researchers started a retrospective study to investigate how CFTR modulation therapy might alter the behavior of Pseudomonas aeruginosa in the lungs of cystic fibrosis patients.
They performed phenotypic characterization and comparative genomics after isolating 105 strains of P. aeruginosa from the sputum of 11 individuals chronically colonized with cystic fibrosis at baseline and up to 21 months posttreatment with elexacaftor-tezacaftor-ivacaftor or tezacaftor-ivacaftor.
The results showed that clonal lineages of P. aeruginosa persisted after therapy, with no evidence of displacement by alternative strains. Commonly mutated genes among patient isolates, which may be positively selected in the CFTR-modulated lung, were identified. Nevertheless, classic chronic P. aeruginosa phenotypes, including mucoid morphology, were sustained, and isolates maintained similar resistance to clinically relevant antibiotics.
Investigators concluded that CFTR modulators offered relief but didn’t eliminate adaptable P. aeruginosa strains, raising concerns for future treatment in severe CF cases.
Source: academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiae051/7619464
