ePS02.8 Prevalence and clinical associations of fungal airway isolates in the UK adult cystic fibrosis population

Felton, Imogen; Yazbeck, L.; Gunn, E.; Moffatt, MF; Cookson, W. O. C. M.; Loebinger, M.R.; MacNeill, Stephanie J; Bilton, Diana; Simmonds, N.J.

doi:10.1016/s1569-1993(15)30145-4

Cited by 5 publications

(3 citation statements)

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“…increased slightly from 0.07% to 0.68%. 5 The range of fungal species described in CF is expanding in concert with improved culture techniques and increased application of molecular diagnostics. Figure 1 outlines the wide spectrum of fungi which have been isolated in CF and these are grouped based on the current clinical impressions of chronicity and pathogenicity.…”

Section: Epidemiologymentioning

confidence: 99%

The myriad challenges of respiratory fungal infection in cystic fibrosis

Tracy

Moss

2018

Pediatric Pulmonology

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Fungal infection in cystic fibrosis (CF) is a recognized challenge, with many areas requiring further investigation. Consensus definitions exist for allergic bronchopulmonary aspergillus in CF, but the full scope of clinically relevant non-allergic fungal disease in CF-asymptomatic colonization, transient or chronic infection localized to endobronchial mucus plugs or airway tissue, and invasive disease-is yet to be clearly defined. Recent advances in mycological culture and non-culture identification have expanded the list of both potential pathogens and community commensals in the lower respiratory tract. Here we aim to outline the current understanding of fungal presence in the CF respiratory tract, risk factors for acquiring fungi, host-pathogen interactions that influence the role of fungi from bystander to pathogen, advances in the diagnostic approaches to isolating and identifying fungi in CF respiratory samples, challenges of classifying clinical phenotypes of CF patients with fungi, and current treatment approaches. Development and validation of biomarkers characteristic of different fungal clinical phenotypes, and controlled trials of antifungal agents in well-characterized target populations, remain central challenges to surmount and goals to be achieved.

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Section: Epidemiologymentioning

confidence: 99%

The myriad challenges of respiratory fungal infection in cystic fibrosis

Tracy

Moss

2018

Pediatric Pulmonology

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“…Several studies have recognised that the presence of fungi in airway secretions are associated with accelerated clinical decline [8] , [9] , [10] . In adults with CF, Candida, Aspergillus and non- Aspergillus filamentous fungi have all been associated with worse disease and significantly impaired lung function [10] , [11] , [12] , [13] . The rising prevalence and variety of fungi in the sputum of CF patients and their association with severe disease suggest that fungi may directly contribute to airway inflammation, lung function decline and exacerbation rates [ 8 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The fungal airway microbiome in cystic fibrosis and non-cystic fibrosis bronchiectasis

Cuthbertson

Felton

James

et al. 2021

Journal of Cystic Fibrosis

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Background: The prevalence of fungal disease in cystic fibrosis (CF) and non-CF bronchiectasis is increasing and the clinical spectrum is widening. Poor sensitivity and a lack of standard diagnostic criteria renders interpretation of culture results challenging. In order to develop effective management strategies, a more accurate and comprehensive understanding of the airways fungal microbiome is required. The study aimed to use DNA sequences from sputum to assess the load and diversity of fungi in adults with CF and non-CF bronchiectasis. Methods: Next generation sequencing of the ITS2 region was used to examine fungal community composition (n = 176) by disease and underlying clinical subgroups including allergic bronchopulmonary aspergillosis, chronic necrotizing pulmonary aspergillosis, non-tuberculous mycobacteria, and fungal bronchitis. Patients with no known active fungal disease were included as disease controls. Results: ITS2 sequencing greatly increased the detection of fungi from sputum. In patients with CF fungal diversity was lower, while burden was higher than those with non-CF bronchiectasis. The most common operational taxonomic unit (OTU) in patients with CF was Candida parapsilosis (20.4%), whereas in non-CF bronchiectasis sputum Candida albicans (21.8%) was most common. CF patients with overt fungal bronchitis were dominated by Aspergillus spp. , Exophiala spp., Candida parapsilosis or Scedosporium spp. Conclusion: This study provides a framework to more accurately characterize the extended spectrum of fungal airways diseases in adult suppurative lung diseases.

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“…Additionally, rare fungi (e.g., Scedosporium spp.) were detected slightly more often in 2012 (0.68%) than in 2007 (0.07%) [ 17 ]. It has to be noted though that the use of varying culture protocols in studies and nonuniform diagnostic techniques across CF centers partaking in registries makes direct comparison of data complicated.…”

Section: Epidemiologymentioning

confidence: 99%

Update on Respiratory Fungal Infections in Cystic Fibrosis Lung Disease and after Lung Transplantation

Renner

Nachbaur

Jaksch

et al. 2020

JoF

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Cystic fibrosis is the most common autosomal-recessive metabolic disease in the Western world. Impaired trans-membrane chloride transport via the cystic fibrosis transmembrane conductance regulator (CFTR) protein causes thickened body fluids. In the respiratory system, this leads to chronic suppurative cough and recurrent pulmonary infective exacerbations, resulting in progressive lung damage and respiratory failure. Whilst the impact of bacterial infections on CF lung disease has long been recognized, our understanding of pulmonary mycosis is less clear. The range and detection rates of fungal taxa isolated from CF airway samples are expanding, however, in the absence of consensus criteria and univocal treatment protocols for most respiratory fungal conditions, interpretation of laboratory reports and the decision to treat remain challenging. In this review, we give an overview on fungal airway infections in CF and CF-lung transplant recipients and focus on the most common fungal taxa detected in CF, Aspergillus fumigatus, Candida spp., Scedosporium apiospermum complex, Lomentospora species, and Exophiala dermatitidis, their clinical presentations, common treatments and prophylactic strategies, and clinical challenges from a physician’s point of view.

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ePS02.8 Prevalence and clinical associations of fungal airway isolates in the UK adult cystic fibrosis population

Cited by 5 publications

References 0 publications

The myriad challenges of respiratory fungal infection in cystic fibrosis

The myriad challenges of respiratory fungal infection in cystic fibrosis

The fungal airway microbiome in cystic fibrosis and non-cystic fibrosis bronchiectasis

Update on Respiratory Fungal Infections in Cystic Fibrosis Lung Disease and after Lung Transplantation

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