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. 2020 May 22;S1201-9712(20)30370-2.
doi: 10.1016/j.ijid.2020.05.063. Online ahead of print.

A 16-year Retrospective Study on Fungal Prevalence and Diversity in Patients With Cystic Fibrosis- Candida Dubliniensis Was Associated With a Decline in Lung Function

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A 16-year Retrospective Study on Fungal Prevalence and Diversity in Patients With Cystic Fibrosis- Candida Dubliniensis Was Associated With a Decline in Lung Function

Mahasin Al Shakirchi et al. Int J Infect Dis. .

Abstract

Objectives: To study the prevalence of fungal species in CF patients over a 16 years period, as well as the impact of C. albicans, C. dubliniensis and A. fumigatus on lung function.

Methods: Observational single-center cohort study (2000-2015) including 133 CF patients (ages 6-66 years). Linear mixed models with autoregressive covariance matrix were used.

Results: C. albicans was the most common fungus (prevalence 62%) followed by A. fumigatus (22%) and C. dubliniensis (11%). In the initial year of detection, there was no impact of C. albicans, C. dubliniensis or A. fumigatus on lung function. However, one and two years after detection of C. dubliniensis a reduction in ppFEV1 with 3.8%, p=0.022, (year 1) and with 4.1%, p=0.017 (year 2) compared to CF patients without these findings, was observed. Furthermore, patients with positive cultures for any of these fungal species for three consecutive years exhibited a decline in lung function (C. dubliniensis, 7.6% reduction in ppFEV1, p=0.001; A. fumigatus, 4.9%, p=0.007; C. albicans, 2.6%, p=0.014). The results were adjusted for age, CFTR genotype, chronic and intermittent P. aeruginosa colonization and numbers of intravenous antibiotic treatments per year. Persistence of C. dubliniensis for three consecutive years was correlated positively to age and ESR (both p=0.001).

Conclusions: CF patients who were cultured positive for C. dubliniensis, C. albicans or A. fumigatus in sputum exhibited a decline in ppFEV1 over time. The effect was most pronounced for C. dubliniensis.

Keywords: Aspergillus fumigatus.; Candida albicans; Candida dubliniensis; Cystic fibrosis; moulds; yeasts.

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