Early infection and progression of cystic fibrosis lung disease.

Chronic Pseudomonas aeruginosa infection is the major limitation in overall survival of patients with cystic fibrosis, and elective bronchoscopy shows that infection with this organism starts at a very early age. Early infection with nonmucoid P. aeruginosa gradually develops into chronic infection, characterized by the presence of microcolonies of alginate-producing (mucoid) P. aeruginosa in the bronchial tree. Chronic infection cannot be cured, but aggressive antimicrobial treatment will prolong life expectancy and decrease morbidity. It has, however, over the last decade become evident that early antimicrobial treatment of the initial infection with nonmucoid strains can prevent or at least postpone transition into chronic (mucoid) infection. This treatment strategy is likely to dramatically improve the prognosis of patients with cystic fibrosis in the immediate future. Copyright 2002 Wiley-Liss, Inc.