In the largest study of its kind, involving 191 patients, researchers at the Ann & Robert H. Lurie Children’s Hospital in Chicago, found that the lower airways in children with cystic fibrosis (CF) are distinct and have a higher burden of infection, more inflammation and lower diversity of microorganisms, compared to children with other illnesses who also have lung issues. The multicenter study, which analysed lower airway samples from 63 patients with cystic fibrosis aged 0-21 years, established a clear divergence in these bacterial communities in toddlers, prior to this progressive lung disease taking hold in patients with cystic fibrosis. These findings are expected to help healthcare providers target specific pathogens earlier, treat them and potentially prevent more severe lung disease.