UK CF Microbiology Consortium

With the support of a Big Lottery Fund grant of over £500,000, we are undertaking a special research programme to help tackle the very serious and changing problem of infection which all of those with CF face by setting up the UK CF Microbiology Consortium.

The prompt and appropriate use of antibiotics to control lung infections is essential to increase the length and quality of life for those with Cystic Fibrosis. However, we also recognise that bacteria can become resistant to antibiotics. We are reminded of this almost daily, with media stories of highly adaptable superbugs. Whilst much of what we hear may be scaremongering, we know that lung infection with certain bacteria may present a serious threat to those with Cystic Fibrosis. And the sad fact remains that of those who succumb to CF, 90% of them do so as a result of lung failure.

Whilst the policy of segregation to prevent infection from spreading between those with CF does
help to contain the problem, it also places a considerable social and personal strain on families and individuals, who are denied the emotional support of friendship with others who share their experiences.

This programme of research, under the expert leadership of Professor John Govan at the Medical Microbiology Division, Centre for Infectious Diseases, University of Edinburgh, aims to address five key aspects of the control of infection in those with CF, which is of huge importance to those coping with this condition.

The first is research to identify ways of reducing the delay of several days, or even weeks, in identifying which infection or bug is present and responsible for impaired lung function. The approaches being explored are groundbreaking and will, if effective, produce results within hours rather than days or weeks. This will not only enable effective treatment of the particular strain of Pseudomonas aeruginosa or Burkholderia cepacia complex to begin immediately, it will also minimise unnecessary segregation and exclusion, whilst alerting clinical teams as to when segregation may be necessary.

The second and third research themes aim to establish which strains of bacteria affecting patients with CF are particularly virulent and/or transmissible, and identify what bacterial and host factors are important. This will enable us to understand better when segregation is advisable, and just as importantly, when it is not.

The fourth aspect of this research programme is in response to the reduced prospects of new antibiotics being developed by the pharmaceutical industry. The CF Community desperately needs new drugs so it falls to us to try to develop them. Novel ways of doing this will be explored. To give you some idea of the complexity of the research planned, genomic sequence data, recombinant DNA technology, synthetic chemistry and mass spectrometry will be used to investigate the link between structure and antimicrobial activity in major disinfectants and in beta defensins and other cationic peptides.

As you will gather, the science is very complex and the detail above is only included to give you a flavour of what is involved. The bottom line is to identify and develop more effective drugs or combinations of drugs to control infection in the lungs of those with Cystic Fibrosis.

The fifth component will identify groundbreaking developments in CF microbiology and, in collaboration with other consortium members, conduct pilot projects to assess their direct clinical relevance. This will be a UK-wide initiative.

Five scientific posts will be funded from this grant, based at the Department of Medical Microbiology, University of Liverpool; the Health Protection Agency, London; the School of Medicine, Queen's University, Belfast; the School of Biological Sciences, University of Cardiff and the Medical Microbiology Division, School of Chemistry, MRC Human Genetics Unit and Centre for Inflammation Research at the University of Edinburgh.

The consortium will benefit considerably from ongoing collaborative research with clinicians in UK CF Centres, including colleagues at Wythenshawe Hospital, Manchester and Papworth Hospital, Cambridge.

This three-year programme of research will enable us to understand more about the nature of the bugs involved in CF, how to control them and how to manage them. We hope it will lead to new drugs and clearer segregation policies than we have followed to date. If as a result, we can recommend less strict segregation policies, no-one will be more pleased than the Cystic Fibrosis Trust.