Clinical significance of the recovery ofAspergillus species from the respiratory secretions of cystic fibrosis patients

Abstract

The frequent recovery of Aspergillus species from the respiratory tract secretions of cystic fibrosis (CF) patients is well recognized, and the presence of the fungus in the airways may trigger an inflammatory response that can manifest as the clinical entity known as allergic bronchopulmonary aspergillosis (ABPA). In our CF patient population we studied the clinical characteristics of those who had Aspergillus sp. recovered from their respiratory tract secretions (n = 45) and compared them with the characteristics seen, during the same time period. In those patients who were culture negative for Aspergillus sp. (n = 167). There were no differences in peripheral blood eosinophil count (P = 0.9) or serum immunoglobulin E levels (P = 0.61). By logistic regression analysis there seemed to be an increased risk for more advanced lung disease, both radiographically (defined by a Brasfield chest radiograph score <18) and by lung function parameters in those who were culture positive. However, after appropriate adjustment, almost all the increased risk was associated with age and gender, but not with the presence of Aspergillus sp. in respiratory secretions. Additionally, increasing age was strongly correlated with the risk of Aspergillus sp. being cultured from respiratory secretions (P = 0.0025). The presence of Aspergillus sp. in respiratory secretions was not associated with two indicators of atopy in our CF patient population. We do not have evidence that the culture of Aspergillus sp. from CF respiratory secretions is independently associated with an increased risk for more advanced lung disease. Pediatr Pulmonol. 1996; 21:6–10. © 1996 Wiley‐Liss, Inc.

Aspergillus fumigatus colonization in cystic fibrosis: implications for lung function?

“…Several other studies have investigated the association between A. fumigatus colonization and lung function crosssectionally. The results from the cross-sectional analysis performed in the present study are similar to those reported by Milla et al An unadjusted association between lung function and A. fumigatus colonization was found that was no longer significant after adjustment for covariates and appeared to be explained by age and gender [6], indicating that the increased risk of advanced pulmonary disease was associated with demographic factors that have been reported to be associated with severity of lung disease [18]. Another cross-sectional study by Bargon et al also found no significant association between A. fumigatus colonization (defined as at least two cultures positive out of a minimum of four) and lung function, in a population of adult CF patients.…”

“…The results from the cross‐sectional analysis performed in the present study are similar to those reported by Milla et al. An unadjusted association between lung function and A. fumigatus colonization was found that was no longer significant after adjustment for covariates and appeared to be explained by age and gender [6], indicating that the increased risk of advanced pulmonary disease was associated with demographic factors that have been reported to be associated with severity of lung disease [18]. Another cross‐sectional study by Bargon et al.…”

Aspergillus Species and Other Molds in Respiratory Samples from Patients with Cystic Fibrosis: a Laboratory-Based Study with Focus on Aspergillus fumigatus Azole Resistance

“…In our study, patients persistently colonized with Aspergillus had more pronounced obstructive lung disease, but the association was not statistically significant. Moreover, we found that persistently colonized patients were older, and the proportion of females in this group was higher, supporting similar findings reported by others (35). Traditionally, diabetes has been considered a predisposing condition for fungal infections, but surprisingly, a recent French study showed that diabetes was less common in patients with Aspergillus than in those without it (40).…”

Co-colonisation with Aspergillus fumigatus and Pseudomonas aeruginosa is associated with poorer health in cystic fibrosis patients: an Irish registry analysis

“…A retrospective study on 236 patients with CF found that 25% of patients had positive AF culture results but of these only 15 patients (6.5% of the total population) were ABPA positive [41]. In parallel with our findings, positive culture results for Aspergillus did not seem to represent a specific risk factor for ABPA [40, 42]. …”