Objectives: To study the prevalence and identify the species (yeast and / or filamentous) fungal colonization involved in the bronchial tree in patients with cystic fibrosis. Secondarily to evaluate the influence of Aspergillus colonization on the serological response.
Materials and Methods: Retrospective analysis of 416 sputum from 140 patients with cystic fibrosis, non-transplant patients, aged 1 to 47 years. These samples were received at the laboratory over a period of 30 months (January 2006 to June 2008). The results of fungal cultures were then confronted with the results of Aspergillus serology.
Results: The most frequently isolated species sputum are Candida albicans (n = 240, 57.7%) and Aspergillus fumigatus (n = 223, 53.6%). Only 3.6% of patients (n = 5) exhibited constantly negative cultures during the study period. In contrast, 68.6% of patients (n = 96) had at least one positive culture for C. albicans and 70% (n = 98) at least one positive culture A. fumigatus . The isolation of A. terreus , A. flavus and A. nidulans is less frequent, about 8.6%, respectively (n = 12), 4.3% (n = 6) and 2.9% (n = 4) of patients. Isolation of Scedosporium spp. was observed in 5.7% of patients (n = 8). In total, 19% of patients (n = 26) were colonized by several species of filamentous fungi. The immunological monitoring aspergillosis was conducted for 127 patients but more often away from the mycological analysis, limited to 28 subjects comparison of these data. It appears that a negative serology does not exclude bronchial colonization with Aspergillus spp .. In contrast, Aspergillus strongly positive serology appears to be associated with colonization by several species of Aspergillus .
Conclusion: The prevalence of fungal colonization of the respiratory tract in cystic fibrosis remains high, confirming the literature data. A. fumigatus and C. albicans remains the most frequently encountered species with a similar prevalence. The clinical implication of fungal colonization, particularly associated with a positive serology in impaired lung function in cystic fibrosis remains to be assessed.
Full conference title:
- RICAI 28th (2008)