European cystic fibrosis society consensus on standards--a roadmap to "best care"

Analysis of the bacterial communities present in lungs of patients with cystic fibrosis from American and British centers

The aim of this study was to determine whether geographical differences impact the composition of bacterial communities present in the airways of cystic fibrosis (CF) patients attending CF centers in the United States or United Kingdom. Thirty-eight patients were matched on the basis of clinical parameters into 19 pairs comprised of one U.S. and one United Kingdom patient. Analysis was performed to determine what, if any, bacterial correlates could be identified. Two culture-independent strategies were used: terminal restriction fragment length polymorphism (T-RFLP) profiling and 16S rRNA clone sequencing. Overall, 73 different terminal restriction fragment lengths were detected, ranging from 2 to 10 for U.S. and 2 to 15 for United Kingdom patients. The statistical analysis of T-RFLP data indicated that patient pairing was successful and revealed substantial transatlantic similarities in the bacterial communities. A small number of bands was present in the vast majority of patients in both locations, indicating that these are species common to the CF lung. Clone sequence analysis also revealed that a number of species not traditionally associated with the CF lung were present in both sample groups. The species number per sample was similar, but differences in species presence were observed between sample groups. Cluster analysis revealed geographical differences in bacterial presence and relative species abundance. Overall, the U.S. samples showed tighter clustering with each other compared to that of United Kingdom samples, which may reflect the lower diversity detected in the U.S. sample group. The impact of cross-infection and biogeography is considered, and the implications for treating CF lung infections also are discussed.

Fathers' perspectives on the emotional impact of managing the care of their children with cystic fibrosis

In this article, fathers' perspectives on the emotional impact of managing the care of their children with cystic fibrosis (CF) are examined. The constant worry of living with the unpredictability of CF was highlighted in this study, drawing on interviews with eight Irish fathers, who experienced difficulties communicating their concerns to others. Despite efforts at not dwelling on CF, fathers described being surrounded by constant reminders. To minimize the emotional impact of managing their children's care, fathers described living from day to day rather than looking into the future. These findings demonstrate the need for supportive interventions in helping fathers manage the emotional demands of caring for their children with CF.