CF Bacteria and Bugs

Cystic fibrosis results in a buildup of mucus in the lungs. Sadly this makes catching bacterial infections so much easier as they quite literally stick to the mucus in the lungs - and once they’re in, the mucus makes the perfect environment for a lot of bugs to thrive.

Someone without CF can easily breathe in bacteria but will either be able to clear it by breathing out again as the bacteria won’t have any mucus to stick to - or the cilia in the lungs are able to beat the bacteria out of the lungs. Neither of these things are possible for someone with CF.

There’s SO many different CF bugs that Arlo can catch. There’s some ‘minor’ bugs that are very common and slightly less worrying as they are usually easily eradicated by oral antibiotics - like staphylococcus or haemophilus influenzae. But there’s also a handful of much nastier bugs.

With all CF bugs, the aim is to jump on any lung infections ASAP to eradicate the bug from the lungs and to reduce inflammation, reduction in lung function, lung damage and scarring. However, some bugs cannot be completely eradicated from the lungs due to the bacteria either being antibiotic resistant or particularly aggressive. When this happens, the bug is described as being colonised. And it is managed with ongoing physio and other treatments to try and prevent flare ups in the lungs and reduction in lung function.

Below I have outlined some of the bugs that keep us CF mamas awake at night. These are ones we want to avoid as much as possible.

Pseudomonas - There are many different strains of pseudomonas, and it’s incredibly common as it is found in many different places in the environment and in day to day life. This is a bit of a generalisation but pseudomonas tends to thrive anywhere that there is stagnant water. If detected early, it can be treated with antibiotics and eradicated. However, some strains are antibiotic resistant or otherwise harder to treat and therefore can become colonised. Once colonised Pseudomonas can cause a lot of trouble - with regular chest infections flaring up and causing damage and reduced lung function. I did a load of posts on ways to reduce the risk of your child with CF catching pseudomonas but it is sadly incredibly prevalent in day to day life and is a very common bug. According to data compiled by the CF Trust UK in 2018, around 27% of people with cystic fibrosis are living with chronic pseudomonas infections. This number is probably higher now.

Burkholderia cepacia complex - As with pseudomonas, this bacteria also lives in damp or wet places and was first discovered on the skins of mouldy onions in the 1950s. The name contains the word ‘complex’ because there are many different species of Burkholderia bacteria and some are more harmful than others with the more harmful species being treatment resistant. B.cepecia is much rarer than Pseudomonas. According to data collected by the CF Trust UK, around 4% of people with CF are living with a chronic infection of B.cepecia.

Mycobacterium abscessus - This one is really nasty. It is the most common strain of non-tuberculosis mycobacteria (NTM) and is distantly related to tuberculosis. M.abscessuss can cause very serious lung infections for people with cystic fibrosis. It’s so difficult to treat that people with CF who develop M.abscessuss can become ineligible for a lung transplant (because it can travel to other parts of the body so there is a high risk of it affecting the new lungs.) According to the CF Trust UK, around 7% of people with CF in the UK are living with a strain of NTM (as of 2018).

Aspergillus fumigatus - This one is a fungal infection rather than an infection from bacteria. This type of infection can lead to accelerated lung damage and the fungus is becoming resistant to many treatments. It also can get worse post transplant so becomes very relevant when looking at lung transplant eligibility. Again, the CF Trust UK data from 2018 found around 15% of the CF population are living with chronic aspergillus infection.