Detection of Pseudomonas aeruginosa in cystic fibrosis after initiation of CFTR modulators: a systematic review.
Vito Terlizzi, Edoardo Timitilli, Maria Sole Fiumara et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review examined how Pseudomonas aeruginosa is detected in people with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor (ETI), including comparisons of culture and molecular methods. It included 14 observational studies involving 2525 subjects. Chronic P. aeruginosa detection declined from 51.4% at baseline to 24.8% after ETI, and nearly half of colonized subjects had apparent clearance. Some studies nevertheless found P. aeruginosa by molecular methods when cultures were negative, leaving the clinical significance of these discordant results uncertain.
Key findings
- Chronic P. aeruginosa detection fell from 51.4% at baseline to 24.8% after ETI.
- Nearly half of subjects colonized at baseline achieved apparent clearance after ETI.
- Several studies detected P. aeruginosa molecularly despite negative cultures.
Why it matters
ETI is associated with lower bacterial detection and reduced sputum availability, potentially making culture-based surveillance less sensitive. Molecular testing may identify organisms missed by culture, but PCR-positive, culture-negative findings have uncertain clinical and inflammatory significance. These uncertainties matter when interpreting surveillance results in the modulator era.
What to keep in mind
The review included observational studies, and the clinical and inflammatory significance of PCR-positive, culture-negative results remains uncertain.