<i>Scedosporium apiospermum</i> complex in cystic fibrosis; should we treat?

Noni, Maria; Katelari, A.; Kapi, Aikaterini; Stathi, Angeliki; Dimοpoulos, George; Doudounakis, Stavros

doi:10.1111/myc.12634

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…Generally, Staphylococcus aureus is the first colonizer of the CF lung, but by the time the patients reach the adulthood, P. aeruginosa becomes the most frequently isolated bacterium causing chronic lung infections (LiPuma, 2010). Among filamentous fungi, Aspergillus fumigatus (16–58%) and the S. apiospermum species complex (9–10%) are the most prevalent pathogens isolated from CF patients (Noni et al, 2017; Reece et al, 2017). Clinical manifestations and radiological and histopathological appearance of Scedosporium may overlap with other hyaline molds (i.e., Aspergillus and Fusarium spp.)…”

Section: Introductionmentioning

confidence: 99%

“…In these communities, both pathogens and commensals might be found. Although the commensal species are mainly harmless, they might affect the infection through their interactions with other members of the community (Noni et al, 2017). The role of scedosporia in the CF-lung microbiota is not yet completely revealed, but its understanding might help in the fight against infections and to improve the patients’ medical conditions.…”

Section: Introductionmentioning

confidence: 99%

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In vitro Interactions of Pseudomonas aeruginosa With Scedosporium Species Frequently Associated With Cystic Fibrosis

et al. 2019

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Members of the Scedosporium apiospermum species complex are the second most frequently isolated pathogens after Aspergillus fumigatus from cystic fibrosis (CF) patients with fungal pulmonary infections. Even so, the main risk factors for the infection are unrevealed. According to previous studies, bacterial infections might reduce the risk of a fungal infection, but an antibacterial therapy may contribute to the airway colonization by several fungal pathogens. Furthermore, corticosteroids, which are often used to reduce lung inflammation in children and adults with CF, are also proved to enhance the growth of A. fumigatus in vitro. Considering all the above discussed points, we aimed to test how Pseudomonas aeruginosa influences the growth of scedosporia and to investigate the potential effect of commonly applied antibacterial agents and corticosteroids on Scedosporium species. Direct interactions between fungal and bacterial strains were tested using the disk inhibition method. Indirect interactions via volatile compounds were investigated by the plate-in-plate method, while the effect of bacterial media-soluble molecules was tested using a modified cellophane assay and also in liquid culture media conditioned by P. aeruginosa. To test the effect of bacterial signal molecules, antibacterial agents and corticosteroids on the fungal growth, the broth microdilution method was used. We also investigated the germination ability of Scedosporium conidia in the presence of pyocyanin and diffusible signal factor by microscopy. According to our results, P. aeruginosa either inhibited or enhanced the growth of scedosporia depending on the culture conditions and the mode of interactions. When the two pathogens were cultured physically separately from each other in the plate-in-plate tests, the presence of the bacteria was able to stimulate the growth of several fungal isolates. While in direct physical contact, bacterial strains inhibited the fungal growth. This effect might be attributed to bacterial signal molecules, which also proved to inhibit the germination and growth of scedosporia. In addition, antibacterial agents showed growth-promoting, while corticosteroids exhibited growth inhibitory effect on several Scedosporium isolates. These data raise the possibility that a P. aeruginosa infection or a previously administered antibacterial therapy might be able to increase the chance of a Scedosporium colonization in a CF lung.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

In vitro Interactions of Pseudomonas aeruginosa With Scedosporium Species Frequently Associated With Cystic Fibrosis

et al. 2019

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“…Scedosporium species (spp) is the second most common mold seen in the CF lung after Aspergillus spp . Scedosporium apiospermum complex (includes S. apiospermum sensu stricto, S. boydii , and S. auranticum ) and Lomentospora prolificans (formerly known as Scedosporium prolificans ) have been identified in CF hosts . Despite this, little is known about the characteristics associated with isolation of Scedosporium spp from CF sputum.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, there is poor understanding of the clinical implications of its detection in the airway, with the exception of its role after CF lung transplantation . Case reports and series have described improved outcomes with antifungal therapy in CF patients chronically colonized with S. apiospermum complex . However, systematic investigation of this topic is lacking.…”

Section: Introductionmentioning

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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“…S. apiospermum is an opportunistic fungus causing life-threatening infections in immunocompromised patients (3-5). Chronic pulmonary infections develop mainly in patients with underlying lung disorders, such as tuberculosis, sarcoidosis and cystic fibrosis (6-8). Similar to chronic pulmonary aspergillosis, lung involvement due to S. apiospermum falls into several categories: transient local colonization, bronchopulmonary saprobic involvement, fungus ball formation (scedosporioma), and invasive infection (pneumonia) (3).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary <i>Scedosporium apiospermum</i> Infection with Pulmonary Tumorlet in an Immunocompetent Patient

et al. 2018

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Scedosporium apiospermum is an opportunistic fungus that can cause various types of infections, including localized infections and life-threatening disseminated infections, particularly in immunocompromised patients. Treatment is especially challenging due to its multidrug resistance. We herein report the case of a 73-year-old woman who was non-immunocompromised but developed S. apiospermum lung infection and a pulmonary tumorlet. To our knowledge, this is the first report of the coexistence of pulmonary S. apiospermum infection and tumorlet. The lung lesion was successfully treated by surgical excision without any antifungal agents, and no recurrence of the tumorlet or S. apiospermum infection has occurred.

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Scedosporium apiospermum complex in cystic fibrosis; should we treat?

Cited by 10 publications

References 30 publications

In vitro Interactions of Pseudomonas aeruginosa With Scedosporium Species Frequently Associated With Cystic Fibrosis

In vitro Interactions of Pseudomonas aeruginosa With Scedosporium Species Frequently Associated With Cystic Fibrosis

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

Pulmonary <i>Scedosporium apiospermum</i> Infection with Pulmonary Tumorlet in an Immunocompetent Patient

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