NHMRC ECF (Health Prof RF (PT) - Public Health): Acquisition and transmission of respiratory pathogens in persons with cystic fibrosis (CF): development and implementation of novel molecular tools (2013–2015)
It is now recognised that lung disease may be present early in the life of a person with CF, with abnormalities reported in lung function, pulmonary inflammation and infection, including infection with Pseudomonas aeruginosa. Early diagnosis and treatment of bacterial infection is pivotal to improving clinical outcomes for patients with CF, particularly in young children. The risk of adverse outcomes for children with CF are heightened by highly transmissible, antibiotic resistant P. aeruginosa strains, that are pre-adapted to the CF lung and that have the potential to render early aggressive therapy ineffective. However, traditional diagnosis and typing methods are based on bacterial culture and have many limitations that may lead to pathogens being missed, underestimated or misidentified. In this study, we will develop molecular tools to circumvent these problems. The PCR-based tools developed as part of this study will provide rapid and sensitive detection of these bacterial pathogens, facilitating improved detection of infection earlier in the life of children with CF. The novel Pseudomonas dual sequence fine typing method will provide strain-specific information without the need of an isolate. Combined, these tools will greatly aid CF clinicians in providing earlier and informed treatment of CF pathogens. The data will also provide novel information relating to microevolution of highly prevalent P. aeruginosa strains circulating in CF clinics. Upon successful development and validation of the TaqMan and typing assays, the methods will available for implementation at Microbiology, Pathology Queensland (headed by AI Nimmo). The assays can then be used to enhance detection and characterisation of these important CF pathogens, and will be further disseminated for use elsewhere via publication.