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Thorax 2000;55:349-350 ( May )

Editorial

Maintenance treatment of chronic Pseudomonas aeruginosa infection in cystic fibrosis

The first 150 words of the full text of this article appear below.

Thirty years ago Staphylococcus aureus and not Pseudomonas aeruginosa was considered to be the most important lung pathogen in cystic fibrosis.1 Those who believed that P aeruginosa was a pathogen in cystic fibrosis thought that various virulence factors such as exotoxin A, exoenzyme S, elastase, alkaline protease, phospholipase C, lipopolysaccharide and phenazine pigments were responsible for the lung tissue damage by drawing parallels with acute P aeruginosa infections in patients with burns or leukaemia.2 Only acute exacerbations, frequently caused by a virus,3 were therefore treated with antibiotics, although invasive disseminating P aeruginosa infection including bacteraemia was never found in cystic fibrosis.4 However, a very pronounced antibody response to P aeruginosa antigens, including its virulence factors, was detected in patients with cystic fibrosis and the pathogenesis of the lung tissue damage was subsequently found to be caused by immune complex mediated inflammation dominated by polymorphonuclear leucocytes releasing proteolytic enzymes.5-7 Since the . . . [Full text of this article]




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