Formed by Clinical Strains of Pseudomonas aeruginosa Isolated from Sputum of Cystic Fibrosis Patients
Despite the clinical introduction of a spectrum of therapeutics with anti-bacterial and/or anti-inflammatory activities along with agents facilitating clearance of airways from thick and dehydrated sputum, the mortality rate of patients suffering from cystic fibrosis (CF) is still alarmingly high.1 Chronic inflammation and persistent Pseudomonas aeruginosa colonization are recognized as the major causes of lung tissue damage, lung transplantation, and mortality in CF subjects.2 Regardless of the intravenous or inhaled antibiotic therapies, the efficient treatment of pulmonary infections is considerably hampered mostly by the intrinsic or acquired resistance of P. aeruginosa to a variety of antibiotics,3 which is reinforced by its ability to produce drug-resistant biofilms. The latter is defined as three-dimensional communities of bacteria enclosed and protected by a self-produced extracellular polymeric substance (EPS) matrix, composed of polysaccharides (alginate), lysed cell debris proteins, lipids, extracellular DNA (eDNA), and bacteria-specific factors.4 Importantly, bacteria growth within biofilm in CF lungs is associated with their adaptation to antibiotics used frequently in the therapy of reoccurring pneumonia in CF patients. In this condition, an increased number of mutations associated with antibiotic resistance is generated. Such decreased susceptibility to the applied treatment followed by a lower metabolic rate of biofilm-embedded bacteria and their persistence makes the eradication of biofilms a challenging task.4 An approach to treat lung infections in patients with CF has evolved beyond antibiotic therapy, with the implementation of various airway clearance techniques (ACTs), in particular mucus thinners, to eliminate excess sputum … read more