**Abbreviations**

*Cystic Fibrosis - Heterogeneity and Personalized Treatment*

important to control it in CF patients [67].

rhinovirus [66].

**8. Conclusion**

*Burkholderia cenocepacia*.

prognosis in patients with CF.

everyone in my family for their continual guidance.

The author declares no conflict of interest.

**Acknowledgements**

**Conflict of interest**

suggested a role played by respiratory viruses in exacerbation of CF. The impact of respiratory viruses is likely to be underestimated due to the low detection rate by conventional laboratory methods. Molecular techniques such as multiplex PCR have improved their diagnostic accuracy identifying respiratory viruses in CF patients which are important in clinical decision-making and are potentially important as new antivirals are becoming readily available [64]. A few therapeutic options recorded to treat virus-induced CF pulmonary exacerbations include macrolide antibiotic (azithromycin). It has antiviral properties of the human bronchial epithelial cells and stimulates antiviral mechanisms in bronchial epithelial cells within the CF airway control infection with rhinovirus by reducing rhinovirus replication as an interferon pathway [65]. Also, there are exciting prospects such as antiviral host defense peptides in development and can be novel therapeutics targeting

Additionally, CF patients infected with influenza A(H1N1) showed increased case fatality rate (CFR) and morbidity compared to patients with other chronic respiratory diseases, so, early antibiotic and antiviral treatment strategies are

This chapter concludes that complications of microorganisms associated with

The most common Gram-negative bacterial pathogens are *Pseudomonas aeruginosa* and *Haemophilus influenzae*. Also, the most common Gram-positive bacterial pathogen is *Staphylococcus aureus* especially MRSA. Other bacterial pathogens are isolated from CF patients, such as NTM species, *Alcaligenes xylosoxidans*, and

cystic fibrosis disease are very high and can lead to patient death. Pathogenic microorganisms isolated from CF patients included Gram-negative bacteria, Gram-

In addition, *Candida albicans* is the most common unicellular fungi, and *Aspergillus fumigatus* is the most common filamentous fungi. Influenza A and B viruses are major viruses in causing respiratory exacerbations in CF, and both viruses are more commonly detected during pulmonary exacerbations.

To prevent this microbial complication, appropriate antimicrobials can be used to treat bacterial infections, antifungal therapy for treating pathogenic fungi and antiviral to manage viral infections. With prospects, researchers must work to produce new therapeutic options to control multidrug-resistant bacteria and resistant fungi and virus. These new treatment options may further enhance the

Firstly, great thanks and appreciation to Prof. Dr. Mamdouh Salem Elgamal and Prof. Dr. Ayman Farrag Ahmed for their support and encouragement. Finally, I wish to thank my mother, brother, sisters, children (Khalid and Mohammed), and

positive bacteria, unicellular fungi, multicellular fungi, and viruses.

**30**

