Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi
36 p.
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2017
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sg-ntu-dr.10356-807542020-11-01T05:23:27Z Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi Chmiel, James F. Aksamit, Timothy R. Chotirmall, Sanjay Haresh Dasenbrook, Elliott C. Stuart Elborn, J. LiPuma, John J. Ranganathan, Sarath C. Waters, Valerie J. Ratjen, Felix A. Lee Kong Chian School of Medicine (LKCMedicine) Anaerobic bacteria Aspergillus fumigatus 36 p. Airway infections are a key component of cystic fibrosis (CF) lung disease. Whereas the approach to common pathogens such as Pseudomonas aeruginosa is guided by a significant body of evidence, other infections often pose a considerable challenge to treating physicians. In Part I of this series on the antibiotic management of difficult lung infections, we discussed bacterial organisms including methicillin-resistant Staphylococcus aureus, gram-negative bacterial infections, and treatment of multiple bacterial pathogens. Here, we summarize the approach to infections with nontuberculous mycobacteria, anaerobic bacteria, and fungi. Nontuberculous mycobacteria can significantly impact the course of lung disease in patients with CF, but differentiation between colonization and infection is difficult clinically as coinfection with other micro-organisms is common. Treatment consists of different classes of antibiotics, varies in intensity, and is best guided by a team of specialized clinicians and microbiologists. The ability of anaerobic bacteria to contribute to CF lung disease is less clear, even though clinical relevance has been reported in individual patients. Anaerobes detected in CF sputum are often resistant to multiple drugs, and treatment has not yet been shown to positively affect patient outcome. Fungi have gained significant interest as potential CF pathogens. Although the role of Candida is largely unclear, there is mounting evidence that Scedosporium species and Aspergillus fumigatus, beyond the classical presentation of allergic bronchopulmonary aspergillosis, can be relevant in patients with CF and treatment should be considered. At present, however there remains limited information on how best to select patients who could benefit from antifungal therapy. Accepted version 2017-04-06T04:26:02Z 2019-12-06T13:58:13Z 2017-04-06T04:26:02Z 2019-12-06T13:58:13Z 2014 Journal Article Chmiel, J. F., Aksamit, T. R., Chotirmall, S. H., Dasenbrook, E. C., Stuart Elborn, J., LiPuma, J. J., et al. (2014). Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi. Annals of the American Thoracic Society, 11(8), 1298-1306. 2329-6933 https://hdl.handle.net/10356/80754 http://hdl.handle.net/10220/42229 10.1513/AnnalsATS.201405-203AS en Annals of the American Thoracic Society © 2014 American Thoracic Society. This is the author created version of a work that has been peer reviewed and accepted for publication by Annals of the American Thoracic Society, American Thoracic Society. It incorporates referee’s comments but changes resulting from the publishing process, such as copyediting, structural formatting, may not be reflected in this document. The published version is available at: [http://dx.doi.org/10.1513/AnnalsATS.201405-203AS]. application/pdf |
| institution |
Nanyang Technological University |
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NTU Library |
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Asia |
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Singapore Singapore |
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| language |
English |
| topic |
Anaerobic bacteria Aspergillus fumigatus |
| spellingShingle |
Anaerobic bacteria Aspergillus fumigatus Chmiel, James F. Aksamit, Timothy R. Chotirmall, Sanjay Haresh Dasenbrook, Elliott C. Stuart Elborn, J. LiPuma, John J. Ranganathan, Sarath C. Waters, Valerie J. Ratjen, Felix A. Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi |
| description |
36 p. |
| author2 |
Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet |
Lee Kong Chian School of Medicine (LKCMedicine) Chmiel, James F. Aksamit, Timothy R. Chotirmall, Sanjay Haresh Dasenbrook, Elliott C. Stuart Elborn, J. LiPuma, John J. Ranganathan, Sarath C. Waters, Valerie J. Ratjen, Felix A. |
| format |
Article |
| author |
Chmiel, James F. Aksamit, Timothy R. Chotirmall, Sanjay Haresh Dasenbrook, Elliott C. Stuart Elborn, J. LiPuma, John J. Ranganathan, Sarath C. Waters, Valerie J. Ratjen, Felix A. |
| author_sort |
Chmiel, James F. |
| title |
Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi |
| title_short |
Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi |
| title_full |
Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi |
| title_fullStr |
Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi |
| title_full_unstemmed |
Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi |
| title_sort |
antibiotic management of lung infections in cystic fibrosis. ii. nontuberculous mycobacteria, anaerobic bacteria, and fungi |
| publishDate |
2017 |
| url |
https://hdl.handle.net/10356/80754 http://hdl.handle.net/10220/42229 |
| _version_ |
1683493976124948480 |