Candida albicans chronic colonisation in cystic fibrosis may be associated with inhaled antibiotics

Noni, Maria; Katelari, A.; Kaditis, Athanasios G.; Theochari, I.; Lympari, I.; Alexandrou-Athanassoulis, H.; Doudounakis, Stavros; Dimοpoulos, George

doi:10.1111/myc.12338

Cited by 13 publications

(7 citation statements)

References 31 publications

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“…C. albicans can be isolated from respiratory cultures in up to 75% of patients with CF [81], and the frequent use of antibiotics and inhaled steroids may predispose patients to colonisation with Candida species [53, 57]. There is still debate around the significance of the presence of Candida in the respiratory tract in patients with CF, though limited studies have suggested that chronic respiratory colonisation with C. albicans is associated with worsening of FEV1 in CF [13, 24].…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of Fungal Infections in Cystic Fibrosis

Williams

Ranjendran

Ramage

2016

Curr Fungal Infect Rep

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For a long time, the microbiology of cystic fibrosis has been focussed on Pseudomonas aeruginosa and associated Gram-negative pathogens. An increasing body of evidence has been compiled demonstrating an important role for moulds and yeasts within this complex patient group. Whether or not fungi are active participants, spectators or transient passersby remain to be elucidated. However, functionally, they do appear to play a contributory role in pathogenesis, albeit we do not know if this is a direct or indirect effect. The following review examines some of the key evidence for the role of fungi in CF pathogenesis.

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Section: Introductionmentioning

confidence: 99%

Pathogenesis of Fungal Infections in Cystic Fibrosis

Williams

Ranjendran

Ramage

2016

Curr Fungal Infect Rep

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“…A greater use of chronic suppressive antibiotic therapy has been suggested as one of the potential reasons for this apparent increase in emerging pathogens [10]. In line with these authors, others have suggested that nebulised antibiotics could be a predisposing risk factor for fungal respiratory infections [11, 12]. …”

Section: Introductionmentioning

confidence: 56%

“…Some authors have suggested that nebulised antibiotics could be a predisposing risk factor for fungal respiratory infections [11, 12]. Noni et al [11] found an incidence of 44.6% for chronic colonisation by C. albicans in a cohort of patients with CF and described the independent effect of inhaled antibiotic treatment on the odds of chronic colonisation. In our study, we did not find a significant increase in the isolation of fungi.…”

Section: Discussionmentioning

confidence: 99%

“…are the fungi that are most usually isolated in the respiratory tract of patients with respiratory chronic diseases, such as bronchiectasis [31, 32]. Some authors have suggested that nebulised antibiotics could be a predisposing risk factor for fungal respiratory infections [11, 12]. Noni et al [11] found an incidence of 44.6% for chronic colonisation by C. albicans in a cohort of patients with CF and described the independent effect of inhaled antibiotic treatment on the odds of chronic colonisation.…”

Section: Discussionmentioning

confidence: 99%

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Microbiological Progress in Patients with Bronchial Infection with Pseudomonas aeruginosa Treated with Nebulised Colistin

et al. 2019

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Background: Inhaled antibiotics allow the delivery of higher drug concentrations at the site of infection without the systemic adverse effects observed with the use of parenteral or oral antibiotics. These antibiotics have shown to decrease the number of exacerbations, reduce bacterial load or improve pulmonary function in several chronic respiratory conditions. Objectives: The aim of this study was to describe changes in the bacteriology of sputum in patients with chronic bronchial infection with Pseudomonas aeruginosa treated with nebulised colistin. Material and Methods: All patients with chronical infection with P. aeruginosa treated with nebulised colistin attending a day care unit during a 5-year (January 2010 to December 2014) period were included. Repeated-measures t tests were used to assess whether the introduction of colistin was associated with changes in the number of exacerbations or the length of the hospitalisations. Results: Treatment with colistin was associated with a decrease in the number of ambulatory exacerbations (1.87–1.1, p = 0.007), of hospital exacerbations (1.3–0.7, p = 0.010) and of length of stay (15.7–8.6 days, p = 0.005). There was no linear trend in the proportion of isolate Enterobacteriaceae, gram-positive cocci, Haemophilus influenzae or fungi. Isolation of Enterobacteriaceae within 1 year after the beginning of the treatment with nebulised colistin was associated with an increase in the number of ambulatory exacerbations (incidence rate ratio 1.99, 95% CI 1.05–3.79). Conclusions: Nebulised colistin was effective in the treatment of chronic infection with P. aeruginosa, and no significant changes in the microbiological evolution were observed. Isolation of Enterobacteriaceae within 1 year after the beginning of the treatment with nebulised colistin was associated with an increase in the number of exacerbations.

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“…To date, there are no international criteria available for fungal chronic colonisation in CF patients. Several studies have defined fungal chronic colonisation as the presence of fungus in >50% of cultures or the presence of two or more positive cultures in a given year . Especially for S. apiospermum complex, data are still limited and ambiguous .…”

Section: Methodsmentioning

confidence: 99%

Scedosporium apiospermum complex in cystic fibrosis; should we treat?

Noni

Katelari

Kapi

et al. 2017

Mycoses

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Species of the Scedosporium apiospermum complex are the second most frequent filamentous fungi after Aspergillus fumigatus that can be found in cystic fibrosis (CF). Mixed colonisation by S. apiospermum complex and A. fumigatus is also quite common. In this study we summarise all CF patients who were colonised by S. apiospermum complex during their childhood and we present two CF patients who were treated as fungal bronchitis due to S. apiospermum complex. The medical records of 400 CF patients were reviewed in order to identify those with positive respiratory cultures for S. apiospermum complex. Scedosporium apiospermum complex was isolated in 10 CF patients and six of them had more than two positive sputum cultures during the study period. By the time of first isolation, the median age was 14.5 years, the median BMI was 19.41 kg/m , the median predicted FEV % was 78.65% and six patients had a history of A. fumigatus isolation. Two patients presented symptoms of infection while they were colonised by S. apiospermum complex. A rapid remission of their symptoms was observed only when antifungal therapy was administered. Antifungal treatment should be considered in CF patients who present symptoms of infection not responding to antibacterial therapy and S. apiospermum complex is persistently growing in sputum cultures.

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Candida albicans chronic colonisation in cystic fibrosis may be associated with inhaled antibiotics

Cited by 13 publications

References 31 publications

Pathogenesis of Fungal Infections in Cystic Fibrosis

Pathogenesis of Fungal Infections in Cystic Fibrosis

Microbiological Progress in Patients with Bronchial Infection with <b><i>Pseudomonas aeruginosa</i></b> Treated with Nebulised Colistin

Scedosporium apiospermum complex in cystic fibrosis; should we treat?

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