**3. A friend or a foe?**

Normally, tuberculosis is rare among CF patients, and it was found to complicate the CF disease condition. It is also interesting to know that the CF disease condition will not support growth of TB mycobacteria (*Mycobacterium tuberculosis*) and the risk of TB in these patients is high in areas with high prevalence. In addition, other chronic illnesses such as poorly controlled diabetes were considered as an additional risk factor among CF patients.

Among non-typical mycobacteria (NTM), *M. abscessus* is considered the most clinically virulent species. Isolation of NTM is common in CF patients before lung transplantation as revealed by data from a large US center. However, reports

**3**

provided the original work is properly cited.

\*Address all correspondence to: d.sriramulu@gmail.com

capita antibiotic consumption of a nation.

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

*Introductory Chapter: Pseudomonas aeruginosa - Toward Omnipresence*

mention high variability in infection rates predominantly with single species and rarely by two mycobacteria due to several factors from diversity in methodology, number of patients involved in the studies, geographical and racial differences, and the age factor, with some ambiguity in the case of gender basis. Adolescents and young adults (10–25 years age) are prone to NTM infections with rapidly growing strains infecting patients of all age groups. The slow-growing species *M. avium*, *M. intracellulare*, and other genetically related species are prevalent in North America, whereas the rapidly growing *M. abscessus* prevails in Western Europe and Israel. Infrequent prevalence was reported for *M. fortuitum*, *M. gordonae*, *M. kansasii*, *M. simiae*, *M. peregrinum*, and *M. malmoense* [7]. However, survival of CF patients infected with NTM before transplantation is reported to be similar to that of patients without NTM infection. Overall, the predominance of *P. aeruginosa* could help keep a check on infections by other pathogenic

Huge genetic repertoire and mosaic genome structure of *P. aeruginosa* make it a versatile opportunistic pathogen in nosocomial settings, particularly in conditions involving burns and wounds, meningitis, endocarditis, and microbial keratitis. Interestingly, *P. aeruginosa* displays a common phenotype in the CF lung irrespective of the genetic content, which includes mucoidy, lipopolysaccharide modifications, lack of flagella and pili, upregulated antibiotic efflux, etc. New forms of emerging resistance in bacteria spread rapidly by intra- and interspecies acquisition of genetic content from the environment where community biofilms are common. In addition to being a threat to public health, highest resistance rates correlate with highest per

*DOI: http://dx.doi.org/10.5772/intechopen.86427*

bacteria [8].

**4. The concern**

**Author details**

Dinesh Sriramulu Shres Consultany, India *Introductory Chapter: Pseudomonas aeruginosa - Toward Omnipresence DOI: http://dx.doi.org/10.5772/intechopen.86427*

mention high variability in infection rates predominantly with single species and rarely by two mycobacteria due to several factors from diversity in methodology, number of patients involved in the studies, geographical and racial differences, and the age factor, with some ambiguity in the case of gender basis. Adolescents and young adults (10–25 years age) are prone to NTM infections with rapidly growing strains infecting patients of all age groups. The slow-growing species *M. avium*, *M. intracellulare*, and other genetically related species are prevalent in North America, whereas the rapidly growing *M. abscessus* prevails in Western Europe and Israel. Infrequent prevalence was reported for *M. fortuitum*, *M. gordonae*, *M. kansasii*, *M. simiae*, *M. peregrinum*, and *M. malmoense* [7]. However, survival of CF patients infected with NTM before transplantation is reported to be similar to that of patients without NTM infection. Overall, the predominance of *P. aeruginosa* could help keep a check on infections by other pathogenic bacteria [8].
