Non-cystic fibrosis bronchiectasis: The long road to multidrug resistant bacteria
Multidrug resistance and bronchiectasis
Keywords:
Disease progression, multidrug‑resistant bacteria, noncystic fibrosis bronchiectasisAbstract
Bronchiectasis is a common progressive respiratory disease characterized by exacerbations and recurrent chest infections with high morbidity and reduced quality of life. Cole«SQ»s vicious cycle model explains the evolution of this disease, in which an initial insult in the bronchi, often on a background of impaired mucociliary clearance or bactericidal activity, results in persistence of microbes in the sinobronchial tree and microbial colonization. Microbial overgrowth then causes infection and chronic inflammation, resulting in tissue damage, and impaired mucociliary motility. Subsequent antimicrobial treatments, microbiota interactions, and hypermutation can favor the development of resistance and the appearance of multidrug-resistant (MDR) bacteria. In this paper, we summarize the current knowledge on how bacteria become MDR in noncystic fibrosis bronchiectasis, and which are the most common bacterial pathogens, excluding Mycobacteria.
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