The evolving dynamics of the microbial community in the cystic fibrosis lung

The cystic fibrosis (CF) lung is a niche colonized by a diverse group of organisms, with a more limited number of species including Pseudomonas aeruginosa dominating in adult patients. Whether all members of this microbial community play a direct or indirect role in pulmonary decline has yet to be fully elucidated, but investigations of their interactions with both co-colonizing species and with host cells are beginning to shed light on their virulence potential. It is also emerging that some microbial species within this community adapt as chronic infection is established to survive the hostile environment of the lung, to minimize host clearance and to resist therapeutic intervention. This review highlights the recent developments in CF microbiology focusing on the cooperative, competitive and adaptive interactions of established and emerging pathogens in the lung microbiome.