Prophylactic antibiotic therapy is associated with an increased prevalence of Aspergillus colonization in adult cystic fibrosis patients

Bargon, Joachim; Dauletbaev, Nurlan; Kohler, Benedikt; Wolf, M.; Posselt, Hans-Georg; Wagner, Thomas

doi:10.1016/s0954-6111(99)90270-6

Cited by 88 publications

(77 citation statements)

References 16 publications

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“…Among adult patients with CF, prophylactic antibiotics (both oral and aerosolized agents) were risk factors for colonization with Aspergillus spp. but the lung function was not decreased in colonized patients (12). Similarly, more frequent acquisition of Aspergillus spp.…”

Section: Fungi and Moldsmentioning

confidence: 86%

Infection Control in Cystic Fibrosis

2004

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Over the past 20 years there has been a greater interest in infection control in cystic fibrosis (CF) as patient-to-patient transmission of pathogens has been increasingly demonstrated in this unique patient population. The CF Foundation sponsored a consensus conference to craft recommendations for infection control practices for CF care providers. This review provides a summary of the literature addressing infection control in CF. Burkholderia cepacia complex, Pseudomonas aeruginosa, and Staphylococcus aureus have all been shown to spread between patients with CF. Standard precautions, transmission-based precautions including contact and droplet precautions, appropriate hand hygiene for health care workers, patients, and their families, and care of respiratory tract equipment to prevent the transmission of infectious agents serve as the foundations of infection control and prevent the acquisition of potential pathogens by patients with CF. The respiratory secretions of all CF patients potentially harbor clinically and epidemiologically important microorganisms, even if they have not yet been detected in cultures from the respiratory tract. CF patients should be educated to contain their secretions and maintain a distance of >3 ft from other CF patients to avoid the transmission of potential pathogens, even if culture results are unavailable or negative. To prevent the acquisition of pathogens from respiratory therapy equipment used in health care settings as well as in the home, such equipment should be cleaned and disinfected. It will be critical to measure the dissemination, implementation, and potential impact of these guidelines to monitor changes in practice and reduction in infections

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Section: Fungi and Moldsmentioning

confidence: 86%

Infection Control in Cystic Fibrosis

2004

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“…Aspergillus sp. are found in the sputum cultures of 20 -40% (10,13,14,24) of CF patients and is not currently treated outside of the coexisting diagnosis of ABPA. Although conidia are the morphotype of Aspergillus normally inhaled, the antigenic components of the fungus exist in the hyphal form (19).…”

Section: Discussionmentioning

confidence: 99%

Aspergillus fumigatus Generates an Enhanced Th2-Biased Immune Response in Mice with Defective Cystic Fibrosis Transmembrane Conductance Regulator

Allard

Poynter

Marr

et al. 2006

The Journal of Immunology

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Cystic fibrosis (CF) lung disease is characterized by persistent airway inflammation and airway infection that ultimately leads to respiratory failure. Aspergillus sp. are present in the airways of 20–40% of CF patients and are of unclear clinical significance. In this study, we demonstrate that CF transmembrane conductance regulator (CFTR)-deficient (CFTR knockout, Cftrtm1Unc-TgN(fatty acid-binding protein)CFTR) and mutant (ΔF508) mice develop profound lung inflammation in response to Aspergillus fumigatus hyphal Ag exposure. CFTR-deficient mice also develop an enhanced Th2 inflammatory response to A. fumigatus, characterized by elevated IL-4 in the lung and IgE and IgG1 in serum. In contrast, CFTR deficiency does not promote a Th1 immune response. Furthermore, we demonstrate that CD4+ T cells from naive CFTR-deficient mice produce higher levels of IL-4 in response to TCR ligation than wild-type CD4+ T cells. The Th2 bias of CD4+ T cells in the absence of functional CFTR correlates with elevated nuclear levels of NFAT. Thus, CFTR is important to maintain the Th1/Th2 balance in CD4+ T cells.

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“…Milla and colleagues compared lung function in 45 CF patients with Aspergillus grown from their respiratory secretions to that in 167 patients who were culture negative (399 (35). The Aspergillus-positive and -negative groups were fairly equivalent with regard to age and gender distribution, and no difference in % predicted FEV 1 was observed between them.…”

Section: Aspergillus Speciesmentioning

confidence: 99%

Clinical Significance of Microbial Infection and Adaptation in Cystic Fibrosis

et al. 2011

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SUMMARY A select group of microorganisms inhabit the airways of individuals with cystic fibrosis. Once established within the pulmonary environment in these patients, many of these microbes adapt by altering aspects of their structure and physiology. Some of these microbes and adaptations are associated with more rapid deterioration in lung function and overall clinical status, whereas others appear to have little effect. Here we review current evidence supporting or refuting a role for the different microbes and their adaptations in contributing to poor clinical outcomes in cystic fibrosis.

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Prophylactic antibiotic therapy is associated with an increased prevalence of Aspergillus colonization in adult cystic fibrosis patients

Cited by 88 publications

References 16 publications

Infection Control in Cystic Fibrosis

Infection Control in Cystic Fibrosis

Aspergillus fumigatus Generates an Enhanced Th2-Biased Immune Response in Mice with Defective Cystic Fibrosis Transmembrane Conductance Regulator

Clinical Significance of Microbial Infection and Adaptation in Cystic Fibrosis

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