Infection in cystic fibrosis: impact of the environment and climate

ABSTRACT

In many countries numbers of adults with cystic fibrosis (CF) exceed that of children, with median survival predicted to surpass 50 years. Increasing longevity is, in part, due to intensive therapies including eradication of early infection and suppressive therapies and pulmonary exacerbations. Initial infections with common CF pathogens are thought to arise from the natural environment. We review the impact of climate and environment on infection in CF. Specifically, several studies indicate that higher ambient temperatures, proximity to the equator and the summer season may be linked to the increased prevalence of Pseudomonas aeruginosa in people with CF. The environment may also play an important role in the acquisition of Gram negative organisms other than P. aeruginosa. There is emerging data suggesting that climatic and environmental factors are likely to impact on the risk of infection with NTM and fungi in people which are found extensively throughout the natural environment.

KEYWORDS:

• Cystic fibrosis
• environmental microbiology
• climate
• epidemiology
• infection
• acquisition
• travel
• Pseudomonas aeruginosa
• nontuberculous mycobacteria
• fungi

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Correction to: Infection in cystic fibrosis: impact of the environment and climate

Declaration of interests

KA Ramsay is the recipient of an Australian Postgraduate Award, PhD Scholarship. SC Bell is recipient of a Queensland Health, Health Research Fellowship and receives grant support by NHMRC, CF Foundation Therapeutics (USA), TPCH Foundation and Children’s Health Foundation, Queensland. TJ Kidd is the recipient of an NHMRC Early Career Fellowship and an ERS-EU RESPIRE2 Marie Sklodowska-Curie Postdoctoral Research Fellowship (MC RESPIRE2 first round, 4571-2013). The literature research leading to this review was partly funded by the People Programme of the European Union’s Seventh Framework Programme (FP7/2007-2013) under REA grant agreement 600368.The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.