Cystic Fibrosis (CF) is the most common, life-threatening, inherited disease, found predominantly in Caucasians. CF causes the body to produce abnormally thick and sticky fluid, called mucus, which affects primarily the lungs and digestive system. It is regarded as one of the most common chronic lung diseases in children and young adults.  

From an early age, the lungs of people with CF become colonized and infected with bacteria, with the mucus providing a perfect environment in which to proliferate. This environment is in part responsible for the bacteria creating biofilms, organised communities of bacteria that adhere to a surface, surrounded by a protective layer. As a biofilm, CF lung infections are notoriously difficult to treat. Staphylococcus aureus, Haemophilus influenza and Pseudomonas aeruginosa are the most common bacteria causing lung infections in people with CF.

Treatment for CF lung infections includes antibiotics which are used to prevent or reduce and treat the growth of bacteria. Antibiotics can be given either by mouth, inhaled or through the veins depending on the severity of the infection. The choice of antibiotic, the dosage, and the length of time to take the antibiotic will vary from person to person depending on the circumstances. Individuals with CF may be on antibiotics, even when they are considered healthy, as a preventative measure against potential infection. Antibiotics are a necessity, however, when people with CF develop pneumonia or if they have a significant decrease in lung function (based on an FEV1 or Forced Expiratory Volume Test). While antibiotics are a reality for people with this disease, the fact that the bacteria form biofilms makes infection more challenging to treat. Choosing the correct combination of antibiotics using biofilm susceptibility testing, preferably in advance of an exacerbation or minimally in the initial stages of a worsening infection, can lead to a faster recovery without contributing to increased antibiotic resistance which can be promoted by a trial and error approach in choosing the correct antibiotic regime.

Lung diseases in general, are some of the most common medical conditions worldwide and are caused by a number of factors, including, but not limited to, infections due to bacteria, viruses and less often, fungi. Lower respiratory tract infections, including those of the lungs, generally tend to be far more serious than infections of the upper respiratory tract, as they gradually weaken our ability to consume oxygen from the lungs.

While the most common types of infections found in the lungs are Pneumonia, Bronchitis and Influenza (flu), Pneumonia tends to be the most predominant, with the majority of cases being caused by bacteria. Pneumonia is common across all age groups, however the very young and old, those who have weakened immune systems and individuals who have pre-existing lung disease, such as those with Cystic Fibrosis, tend to be more at risk. Similar to most other chronic infections, the bacteria that cause lung infections exist as biofilms, contributing to the persistence of these infections and the challenges involved in treating them.

Pneumonia is generally classified as being community acquired (CAP), healthcare associated (HCAP) or hospital-acquired (HAP) depending on where the infection was contracted.

CAP is the most common type of pneumonia, occurring in individuals who have not recently been hospitalized. Streptococcus pneumoniae, Haemophilus influenzae, Chlamydia pneumoniae, and Mycobacterium pneumoniae are the most common bacterial causes of CAP.

HCAP occurs in health care settings, excluding hospitals, such as nursing homes, dialysis centers, and outpatient clinics.

HAP is defined as infection that occurs when a patient develops pneumonia as a result of a hospital stay, and is one of the most common causes of hospital acquired infections. HAP can have serious implications, particularly if a patient is in the ICU (Intensive Care Unit). Patients located in the ICU often require mechanical ventilation, essentially breathing assistance through a tube, making them more likely to develop a specific type of HAP, known as Ventilator Associated Pneumonia (VAP). Virtually all patients requiring mechanical ventilation will develop a biofilm infection within a week. The death rate from these infections is over 50%.

HAP can be caused by a number of different bacteria including gram-negative bacteria such as Pseudomonas aeruginosa, Klebsiella pneumonia and Escherichia coli as well as gram-positive organisms such as Staphylococcus aureus.

As with all bacterial infections, bacterial pneumonia is treated using antibiotics. Because on many occasions, the causative organism is difficult to identify, doctors will often choose antibiotics based on the organisms that are most likely to be causing pneumonia and the severity of illness.

Staph (Staphylococcus) infections are caused by group of about 30 different bacteria, which are generally found in the nose or on the skin of approximately 25%-30% of healthy adults. The most common bacteria within this group, accounting for the majority of infections, is Staphylococcus aureus.

Generally speaking these bacteria do not cause any disease, however if the skin is punctured or broken for any reason, staph bacteria can enter the wound and cause an infection. This in turn can lead to anything from a relatively harmless infection such as a minor skin irritations, to more serious and life threatening illnesses which occur when the bacteria moves from a break in the skin into the bloodstream. This can lead to infections in other parts of the body, such as the lungs (Pneumonia), bones (Osteomyelitis), joints, heart (Endocarditis), blood, and central nervous system. Infections caused by invasive medical devices, such as central venous catheters or urinary catheters, are often associated with Staphylococcus aureus bacteria.

Staph infections are generally treated with antibiotics either topically, orally or intravenously depending on the type of infection. MRSA or Methicillin Resistant Staphylococcus Aureus, is a specific strain of staph that is resistant to most of the commonly used staph antibiotics. Individuals with weakened immune systems, particularly patients within a hospital environment, are at greater risk of developing MRSA infections.

In the case of more serious or chronic infections, the choice of antibiotic depends on the susceptibility of the particular staphylococcal strain as determined by a laboratory test.

In understanding how bacteria respond to antibiotics, it is important to know that 80% of human infections are caused by microorganisms (bacteria or fungi) in a biofilm state, organized communities of microorganisms that adhere to a surface and are encased in a protective layer, rather than free-floating (planktonic) organisms.  Biofilms are 1000 times more resistant to antibiotics than similar organisms in the free-floating state.

Until now, the laboratory test used to determination which antibiotic to use in treating a staph, or any other bacterial infection, has been the MIC test (Minimum Inhibitory Concentration Test). This test, however was designed with the free-floating organism in mind and therefore can potentially lead to an incorrect choice of antibiotic, which in turn means that the infection may not improve and the chances of antibiotic resistance are increased.

Innovotech’s biofilm susceptibility tests, however, takes into account the fact that most of these infections, including those cause by staph, are caused by biofilms. As a result of Innovotech’s test, physicians are more likely to choose “The right antibiotic – right from the start.”*

Disclaimer: All in-house human biofilm bacterial susceptibility testing and associated Information are to be used for research or informational purposes only and are not intended to be used for any medical, diagnostic, regulatory or any other purposes whatsoever. The human biofilm susceptibility tests and associated Information are not approved by the U.S. Food and Drug Administration. bioFILM PA™ has been approved by Health Canada.