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17 pages, 1861 KiB

Open AccessReview

Overcoming Pseudomonas aeruginosa in Chronic Suppurative Lung Disease: Prevalence, Treatment Challenges, and the Promise of Bacteriophage Therapy

by Jagdev Singh, Melinda Solomon, Jonathan Iredell and Hiran Selvadurai

Antibiotics 2025, 14(5), 427; https://doi.org/10.3390/antibiotics14050427 - 23 Apr 2025

Viewed by 1619

Abstract

Pseudomonas aeruginosa, a multidrug-resistant pathogen, significantly impacts patients with chronic respiratory conditions like cystic fibrosis (CF) and non-CF chronic suppurative lung disease (CSLD), contributing to progressive lung damage and poor clinical outcomes. This bacterium thrives in the airway environments of individuals with impaired mucociliary clearance, leading to persistent infections and increased morbidity and mortality. Despite advancements in management of these conditions, treatment failure remains common, emphasising the need for alternative or adjunctive treatment strategies. Bacteriophage therapy, an emerging approach utilising viruses that specifically target bacteria, offers a potential solution to combat P. aeruginosa infections resistant to conventional antibiotics. This review examines the prevalence and disease burden of P. aeruginosa in CF and CSLD, explores the mechanisms behind antibiotic resistance, the promising role of bacteriophage therapy and clinical trials in this sphere. Full article

(This article belongs to the Section Bacteriophages)

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10 pages, 233 KiB

Open AccessEntry

Challenges and Recommendations on Digital Health Sources in Pediatric Chronic Suppurative Lung Diseases

by Eleni A. Kortianou, Aspasia Mavronasou, Vaia Sapouna, Dafni Moriki and Konstantinos Douros

Encyclopedia 2025, 5(1), 1; https://doi.org/10.3390/encyclopedia5010001 - 27 Dec 2024

Viewed by 1427

Definition

In the context of digitalizing healthcare systems, digital health sources (DHSs) aim to enhance the efficiency, accessibility, and quality of healthcare services by leveraging technology. Multiple types of DHSs are increasingly established in healthcare, providing direct and wide communication between pediatric patients, parents, and healthcare professionals. Therefore, they are considered promising key tools to improve pediatric disease monitoring and management. At the same time, DHSs have been associated with several issues and risks, such as those related to data sharing, privacy, and the cultural readiness of the users. Yet, discussions in the literature have mostly focused on technical considerations and a user-friendly design. In contrast, the contribution of DHSs to treatment engagement in pediatric populations and data sharing has only partially been discussed. On this basis, we provide an overview of the available digital health technologies and their application in the pediatric population with chronic suppurative lung diseases; we describe the effectiveness in health-related outcomes, discuss possible challenges, and propose some recommendations that may overcome barriers in their everyday use. Full article

(This article belongs to the Section Medicine & Pharmacology)

26 pages, 1841 KiB

Open AccessReview

The Respiratory Microbiome in Paediatric Chronic Wet Cough: What Is Known and Future Directions

by Brianna Atto, Yitayal Anteneh, Seweryn Bialasiewicz, Michael J. Binks, Mostafa Hashemi, Jane Hill, Ruth B. Thornton, Jacob Westaway and Robyn L. Marsh

J. Clin. Med. 2024, 13(1), 171; https://doi.org/10.3390/jcm13010171 - 28 Dec 2023

Cited by 4 | Viewed by 3366

Abstract

Chronic wet cough for longer than 4 weeks is a hallmark of chronic suppurative lung diseases (CSLD), including protracted bacterial bronchitis (PBB), and bronchiectasis in children. Severe lower respiratory infection early in life is a major risk factor of PBB and paediatric bronchiectasis. In these conditions, failure to clear an underlying endobronchial infection is hypothesised to drive ongoing inflammation and progressive tissue damage that culminates in irreversible bronchiectasis. Historically, the microbiology of paediatric chronic wet cough has been defined by culture-based studies focused on the detection and eradication of specific bacterial pathogens. Various ‘omics technologies now allow for a more nuanced investigation of respiratory pathobiology and are enabling development of endotype-based models of care. Recent years have seen substantial advances in defining respiratory endotypes among adults with CSLD; however, less is understood about diseases affecting children. In this review, we explore the current understanding of the airway microbiome among children with chronic wet cough related to the PBB–bronchiectasis diagnostic continuum. We explore concepts emerging from the gut–lung axis and multi-omic studies that are expected to influence PBB and bronchiectasis endotyping efforts. We also consider how our evolving understanding of the airway microbiome is translating to new approaches in chronic wet cough diagnostics and treatments. Full article

(This article belongs to the Special Issue Novel Insight into Cough: Seed of Respiratory Disease with a Focus on Children)

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7 pages, 241 KiB

Open AccessArticle

Clinical Course of Children with Chronic Suppurative Lung Disease or Bronchiectasis Infected with Pseudomonas aeruginosa

by Elpiniki Kartsiouni, Stylianos Chatzipanagiotou, Angeliki Galani, Dafni Moriki, Olympia Sardeli, Spyridon Prountzos, Efthymia Alexopoulou, Ioanna Loukou, Kostas N. Priftis and Konstantinos Douros

Children 2022, 9(12), 1822; https://doi.org/10.3390/children9121822 - 25 Nov 2022

Cited by 3 | Viewed by 2580

Abstract

Children with chronic wet cough and without cystic fibrosis (non-CF) may suffer from chronic suppurative lung disease (CSLD) or bronchiectasis. Pseudomonas aeruginosa (Pa) can be one of the offending microbes in these children. The present study aimed to describe the clinical course of children with the above two conditions who were infected with Pa. Data of 54 children with CSLD/bronchiectasis who were diagnosed and attended in our department were retrospectively analysed through a Cox proportional hazard model, with age, presence of bronchiectasis, use of inhaled colistin, azithromycin, inhaled hypertonic saline as the covariates. In 42 of the 54 patients, there was no identifiable cause or underlying chronic disorder. Microbiological clearance was defined as the absence of daily wet cough for four months along with four negative cultures taken during the last four consecutive follow-up visits. Multivariate analysis was performed with a Cox proportional hazard model with time to microbiological clearance as the outcome. Results are described as Hazard Ratios (HR) with 95% Confidence Intervals (95%CI). Nebulised antibiotics and the presence of bronchiectasis were statistically significant predictors of remission (HR: 3.99; 95%CI: 1.12–14.14; p = 0.032, and HR: 0.24; 95%CI: 0.08–0.71; p = 0.010). In conclusion, the rate of microbiological clearance increases with the use of inhaled colistin and decreases when there is established bronchiectasis. Full article

(This article belongs to the Special Issue Lung Function, Respiratory and Asthma Disease in Children)

10 pages, 554 KiB

Open AccessArticle

Non-Cystic Fibrosis Bronchiectasis in Pediatric Age: A Case Series in a Metropolitan Area of Northern Italy

by Marcella Gallucci, Egidio Candela, Emanuela Di Palmo, Angela Miniaci and Andrea Pession

Children 2022, 9(9), 1420; https://doi.org/10.3390/children9091420 - 19 Sep 2022

Cited by 6 | Viewed by 3148

Abstract

Non-cystic fibrosis bronchiectasis is an emergent disease characterized by endobronchial suppuration, dilated airways with neutrophilic inflammation and chronic wet cough due to recurrent lower airway infections. A regular clinical follow-up and adequate management of exacerbations are essential to reduce symptoms and the worsening of lung injury. We report a retrospective study comprising 15 children and adolescents with NCFB followed in our hospital center of pediatric pulmonology. We retrospectively analyzed the main comorbidities associated with the presence of NCFB, the radiological aspect associated with the different etiologies and the therapeutic approach used. We also emphasized the importance of an effective preventive strategy to reduce and prevent pulmonary exacerbations. Full article

(This article belongs to the Special Issue Lung Function, Respiratory and Asthma Disease in Children)

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16 pages, 275 KiB

Open AccessReview

Update on Respiratory Fungal Infections in Cystic Fibrosis Lung Disease and after Lung Transplantation

by Sabine Renner, Edith Nachbaur, Peter Jaksch and Eleonora Dehlink

J. Fungi 2020, 6(4), 381; https://doi.org/10.3390/jof6040381 - 21 Dec 2020

Cited by 14 | Viewed by 4005

Abstract

Cystic fibrosis is the most common autosomal-recessive metabolic disease in the Western world. Impaired trans-membrane chloride transport via the cystic fibrosis transmembrane conductance regulator (CFTR) protein causes thickened body fluids. In the respiratory system, this leads to chronic suppurative cough and recurrent pulmonary infective exacerbations, resulting in progressive lung damage and respiratory failure. Whilst the impact of bacterial infections on CF lung disease has long been recognized, our understanding of pulmonary mycosis is less clear. The range and detection rates of fungal taxa isolated from CF airway samples are expanding, however, in the absence of consensus criteria and univocal treatment protocols for most respiratory fungal conditions, interpretation of laboratory reports and the decision to treat remain challenging. In this review, we give an overview on fungal airway infections in CF and CF-lung transplant recipients and focus on the most common fungal taxa detected in CF, Aspergillus fumigatus, Candida spp., Scedosporium apiospermum complex, Lomentospora species, and Exophiala dermatitidis, their clinical presentations, common treatments and prophylactic strategies, and clinical challenges from a physician’s point of view. Full article

(This article belongs to the Special Issue Epidemiology, Diagnosis of Fungal Infections)

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