Early life nasal microbiota in infants with cystic fibrosis

Chronic pulmonary infections are responsible for most of the morbidity and mortality in patients with cystic fibrosis. 1 Mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR) result in increased mucous viscosity and compromised immunity within the lungs of patients with cystic fibrosis. How early colonisation and infections in children arise and contribute to airway physiology is not well understood. The nasopharynx and oropharynx are known to be important reservoirs of cystic fibrosis pathogens, including those associated with infections in young patients (Staphylococcus aureus, Haemophilus influenzae, and even Pseudomonas aeruginosa). 1 , 2 Because CFTR is expressed in the nasal epithelium and CFTR mutations manifest there phenotypically, 3 whether the development of the microbiota in early life is altered in patients with cystic fibrosis is a topic of interest. In The Lancet Respiratory Medicine, Moana Mika and colleagues 4 address this question by comparing development of the nasal microbiome in 30 infants aged 2 months to 1 year with cystic fibrosis with a previously published, age-matched cohort of 47 healthy infants. 5