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Pathogens 2015, 4(1), 66-89;

Bacterial Adaptation during Chronic Respiratory Infections

Centre of Microbial Host Interactions, Institute of Technology Tallaght, Dublin 24, Ireland
Author to whom correspondence should be addressed.
Academic Editor: Marek L. Kowalski
Received: 3 December 2014 / Revised: 15 February 2015 / Accepted: 25 February 2015 / Published: 2 March 2015
(This article belongs to the Special Issue Respiratory Pathogens)
Full-Text   |   PDF [458 KB, uploaded 2 March 2015]   |  


Chronic lung infections are associated with increased morbidity and mortality for individuals with underlying respiratory conditions such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). The process of chronic colonisation allows pathogens to adapt over time to cope with changing selection pressures, co-infecting species and antimicrobial therapies. These adaptations can occur due to environmental pressures in the lung such as inflammatory responses, hypoxia, nutrient deficiency, osmolarity, low pH and antibiotic therapies. Phenotypic adaptations in bacterial pathogens from acute to chronic infection include, but are not limited to, antibiotic resistance, exopolysaccharide production (mucoidy), loss in motility, formation of small colony variants, increased mutation rate, quorum sensing and altered production of virulence factors associated with chronic infection. The evolution of Pseudomonas aeruginosa during chronic lung infection has been widely studied. More recently, the adaptations that other chronically colonising respiratory pathogens, including Staphylococcus aureus, Burkholderia cepacia complex and Haemophilus influenzae undergo during chronic infection have also been investigated. This review aims to examine the adaptations utilised by different bacterial pathogens to aid in their evolution from acute to chronic pathogens of the immunocompromised lung including CF and COPD. View Full-Text
Keywords: respiratory pathogens; bacterial adaptation; chronic infection; evolution; diversification; cystic fibrosis; chronic obstructive pulmonary disease (COPD) respiratory pathogens; bacterial adaptation; chronic infection; evolution; diversification; cystic fibrosis; chronic obstructive pulmonary disease (COPD)

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Cullen, L.; McClean, S. Bacterial Adaptation during Chronic Respiratory Infections. Pathogens 2015, 4, 66-89.

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