Mycobacterium abscessus , an Emerging and Worrisome Pathogen among Cystic Fibrosis Patients

Nontuberculous mycobacteria (NTM) have recently emerged as important pathogens among cystic fibrosis (CF) patients worldwide. is becoming the most worrisome NTM in this cohort of patients and recent findings clarified why this pathogen is so prone to this disease. drug therapy takes up to 2 years and its failure causes an accelerated lung function decline. The colonization of lung alveoli begins with smooth strains producing glycopeptidolipids and biofilm, whilst in the invasive infection, "rough" mutants are responsible for the production of trehalose dimycolate, and consequently, cording formation. Human-to-human transmission was demonstrated among geographically separated CF patients by whole-genome sequencing of clinical isolates worldwide. Using a infected CF zebrafish model, it was demonstrated that (cystic fibrosis transmembrane conductance regulator) dysfunction seems to have a specific role in the immune control of infections only. This pathogen is also intrinsically resistant to many drugs, thanks to its physiology and to the acquisition of new mechanisms of drug resistance. Few new compounds or drug formulations active against are present in preclinical and clinical development, but recently alternative strategies have been investigated, such as phage therapy and the use of β-lactamase inhibitors.