Fungal Respiratory Infections in Cystic Fibrosis (CF): Recent Progress and Future Research Agenda

Bouchara, Jean‐Philippe; Symoens, Françoise; Schwarz, C.; Chaturvedi, Vishnu

doi:10.1007/s11046-017-0241-6

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…and Aspergillus sp. are also associated with CF airway infections (Williams et al, 2016; Bouchara et al, 2018). We therefore examined whether Candida albicans (CA) could be maintained alongside PA in the continuous-flow setup.…”

Section: Resultsmentioning

confidence: 99%

A Continuous-Flow Model for in vitro Cultivation of Mixed Microbial Populations Associated With Cystic Fibrosis Airway Infections

O'Brien

Welch

2019

Front. Microbiol.

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The airways of people with cystic fibrosis (CF) provide a nutrient-rich environment which favours colonisation by a variety of bacteria and fungi. Although the dominant pathogen associated with CF airway infections is Pseudomonas aeruginosa, it is becoming increasingly clear that inter-species interactions between P. aeruginosa and other colonists in the airways may have a large impact on microbial physiology and virulence. However, there are currently no suitable experimental models that permit long-term co-culture of P. aeruginosa with other CF-associated pathogens. Here, we redress this problem by describing a “3R’s-compliant” continuous-flow in vitro culture model which enables long-term co-culture of three representative CF-associated microbes: P. aeruginosa, Staphylococcus aureus and Candida albicans. Although these species rapidly out-compete one another when grown together or in pairs in batch culture, we show that in a continuously-fed setup, they can be maintained in a very stable, steady-state community. We use our system to show that even numerically (0.1%) minor species can have a major impact on intercellular signalling by P. aeruginosa. Importantly, we also show that co-culturing does not appear to influence species mutation rates, further reinforcing the notion that the system favours stability rather than divergence. The model is experimentally tractable and offers an inexpensive yet robust means of investigating inter-species interactions between CF pathogens.

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Section: Resultsmentioning

confidence: 99%

A Continuous-Flow Model for in vitro Cultivation of Mixed Microbial Populations Associated With Cystic Fibrosis Airway Infections

O'Brien

Welch

2019

Front. Microbiol.

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“…The impact of fungi in the CF airway, specifically Scedosporium/Lomentospora , is not yet known and requires rigorous investigation . Parize et al did not detect an association between Scedosporium apiospermum complex serologic status with lung function; however, the association between culture positivity was not evaluated .…”

Section: Discussionmentioning

confidence: 99%

Inhaled antibiotic use is associated with Scedosporium/Lomentospora species isolation in cystic fibrosis

Hong

Lechtzin

Hadjiliadis

et al. 2018

Pediatric Pulmonology

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Introduction: Prevalence of fungi has been rising in the cystic fibrosis (CF) population.Scedosporium species (spp) is the second most common mold seen in the CF respiratory tract. However, the characteristics associated with Scedosporium isolation and its clinical implications are poorly understood. The goal of this study was to determine clinical factors associated with Scedosporium spp to better understand the mechanisms that may contribute to the emergence of filamentous fungi in CF. Methods:We conducted a retrospective cohort study of subjects followed in the CF Foundation PatientPatients under 6 years of age, history of solid organ transplantation, and insufficient respiratory culture data were excluded. We used a multivariable logistic regression model to determine demographic data and baseline disease characteristics, medications and co-infections associated with Scedosporium spp recovery in CF sputum.Results: Among 19 023 subjects, prevalence of Scedosporium spp was 615 (3.2%).Older age (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.07, 1.26) and white race (OR 1.69, 95% CI 1.09, 2.63) were the demographic factors associated with Scedosporium spp isolation. Inhaled antibiotic use had a significant association with Scedosporium isolation (OR 2.01, 95% CI 1.61, 2.52). For every additional course of intravenous antibiotics, the odds of Scedosporium isolation increased by 8% (OR 1.08, 95% CI 1.03, 1.14). Conclusions:The association between inhaled antibiotics and Scedosporium informs us that chronic inhaled antibiotics may be playing a role in Scedosporium isolation. Further investigation to better characterize this relationship is necessary. K E Y W O R D S colonization, epidemiology, fungi, infection

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“…Pathogens in the PSC complex and L. prolificans are persistent colonisers of the lungs of cystic fibrosis (CF) patients, and are the second most frequent moulds after A. fumigatus in the sputum of CF patients and those with underlying respiratory diseases (Cimon et al, 2000;Cooley et al, 2007;Blyth et al, 2010a,b;Sedlacek et al, 2015;Schwarz et al, 2015;Schwarz et al, 2017;Tomazin and Matos, 2017;Bouchara et al, 2018;Schwarz et al, 2018). While chronic airway colonisation of the lung by these fungi can lead to fatal outcomes in CF patients (Borghi et al, 2010), the role of these fungi in CF exacerbation, other than causing acute obstruction (Padoan et al, 2016), is not fully understood.…”

Section: Pseudallescheria/scedosporium Species Complex and Lomentospora Prolificansmentioning

confidence: 99%

Detection of the ‘Big Five’ mold killers of humans: Aspergillus, Fusarium, Lomentospora, Scedosporium and Mucormycetes

Thornton

2020

Advances in Applied Microbiology

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Fungi are an important but frequently overlooked cause of morbidity and mortality in humans. Life-threatening fungal infections mainly occur in immunocompromised patients, and are typically caused by environmental opportunists that take advantage of a weakened immune system. The filamentous fungus Aspergillus fumigatus is the most important and well-documented mould pathogen of humans, causing a number of complex respiratory diseases, including invasive pulmonary aspergillosis, an often fatal disease in patients with acute leukemia or in immunosuppressed bone marrow or solid organ transplant recipients. However, non-Aspergillus moulds are increasingly reported as agents of disseminated diseases, with Fusarium, Scedosporium, Lomentospora and mucormycete species now firmly established as pathogens of immunosuppressed and immunocompetent individuals. Despite well-documented risk factors for invasive fungal diseases, and increased awareness of the risk factors for life-threatening infections, the number of deaths attributable to moulds is likely to be severely underestimated driven, to a large extent, by the lack of readily accessible, cheap, and accurate tests that allow detection and differentiation of infecting species. Early diagnosis is critical to patient survival but, unlike Aspergillus diseases, where a number of CE-marked or FDA-approved biomarker tests are now available for clinical diagnosis, similar tests for fusariosis, scedosporiosis and mucormycosis remain experimental, with detection reliant on insensitive and slow culture of pathogens from invasive bronchoalveolar lavage fluid, tissue biopsy, or from blood. This review examines the ecology, epidemiology, and contemporary methods of detection of these mould pathogens, and the obstacles to diagnostic test development and translation of novel biomarkers to the clinical setting.

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Fungal Respiratory Infections in Cystic Fibrosis (CF): Recent Progress and Future Research Agenda

Cited by 8 publications

References 27 publications

A Continuous-Flow Model for in vitro Cultivation of Mixed Microbial Populations Associated With Cystic Fibrosis Airway Infections

A Continuous-Flow Model for in vitro Cultivation of Mixed Microbial Populations Associated With Cystic Fibrosis Airway Infections

Inhaled antibiotic use is associated with Scedosporium/Lomentospora species isolation in cystic fibrosis

Detection of the ‘Big Five’ mold killers of humans: Aspergillus, Fusarium, Lomentospora, Scedosporium and Mucormycetes

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