Chronic lower respiratory tract infections are a leading contributor to morbidity and mortality in persons with cystic fibrosis (pwCF). Traditional respiratory tract surveillance culturing has focused on a limited range of classic pathogens; however, comprehensive culture and culture-independent molecular approaches have demonstrated complex communities highly unique to each individual. Microbial community structure evolves through the lifetime of pwCF and is associated with baseline disease state and rates of disease progression including occurrence of pulmonary exacerbations. While molecular analysis of the airway microbiome has provided insight into these dynamics, challenges remain including discerning not only "who is there" but "what they are doing" in relation to disease progression. Moreover, the microbiome can be leveraged as a multi-modal biomarker for both disease activity and prognostication. In this article, we review our evolving understanding of the role these communities play in pwCF and identify challenges in translating microbiome data to clinical practice.

中文翻译：

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探索囊性纤维化肺微生物组：充分利用棘手的情况。

慢性下呼吸道感染是囊性纤维化 (pwCF) 患者发病率和死亡率的主要原因。传统的呼吸道监测培养只关注有限范围的经典病原体；然而，综合文化和独立于文化的分子方法已经证明了复杂的社区对每个人来说都是高度独特的。微生物群落结构在 pwCF 的整个生命周期中不断发展，并与基线疾病状态和疾病进展率（包括肺部恶化的发生）相关。虽然气道微生物组的分子分析提供了对这些动态的洞察，但挑战仍然存在，包括识别与疾病进展相关的“谁在那里”以及“他们在做什么”。而且，微生物组可用作疾病活动和预后的多模式生物标志物。在本文中，我们回顾了我们对这些社区在 pwCF 中所起作用的不断发展的理解，并确定了将微生物组数据转化为临床实践的挑战。