{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:30:26Z","timestamp":1775694626599,"version":"3.50.1"},"reference-count":136,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2014,8,18]],"date-time":"2014-08-18T00:00:00Z","timestamp":1408320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Pseudomonas aeruginosa is the most prevalent pathogen of cystic fibrosis (CF) lung disease. Its long persistence in CF airways is associated with sophisticated mechanisms of adaptation, including biofilm formation, resistance to antibiotics, hypermutability and customized pathogenicity in which virulence factors are expressed according the infection stage. CF adaptation is triggered by high selective pressure of inflamed CF lungs and by antibiotic treatments. Bacteria undergo genetic, phenotypic, and physiological variations that are fastened by the repeating interplay of mutation and selection. During CF infection development, P. aeruginosa gradually shifts from an acute virulent pathogen of early infection to a host-adapted pathogen of chronic infection. This paper reviews the most common changes undergone by P. aeruginosa at each stage of infection development in CF lungs. The comprehensive understanding of the adaptation process of P. aeruginosa may help to design more effective antimicrobial treatments and to identify new targets for future drugs to prevent the progression of infection to chronic stages.<\/jats:p>","DOI":"10.3390\/pathogens3030680","type":"journal-article","created":{"date-parts":[[2014,8,18]],"date-time":"2014-08-18T11:17:36Z","timestamp":1408360656000},"page":"680-703","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":228,"title":["Pseudomonas aeruginosa Diversification during Infection Development in Cystic Fibrosis Lungs\u2014A Review"],"prefix":"10.3390","volume":"3","author":[{"given":"Ana","family":"Sousa","sequence":"first","affiliation":[{"name":"CEB\u2014Centre of Biological Engineering, LIBRO\u2014Laborat\u00f3rio de Investiga\u00e7\u00e3o em Biofilmes Ros\u00e1rio Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal"}]},{"given":"Maria","family":"Pereira","sequence":"additional","affiliation":[{"name":"CEB\u2014Centre of Biological Engineering, LIBRO\u2014Laborat\u00f3rio de Investiga\u00e7\u00e3o em Biofilmes Ros\u00e1rio Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2014,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"a009589","DOI":"10.1101\/cshperspect.a009589","article-title":"CFTR, mucins, and mucus obstruction in cystic fibrosis","volume":"2","author":"Kreda","year":"2012","journal-title":"Cold Spring Harb. 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