Prevalence and risk factors for recovery of filamentous fungi in individuals with cystic fibrosis

Sudfeld, Christopher R.; Dasenbrook, Elliott C.; Merz, William G.; Carroll, Karen C.; Boyle, Michael P.

doi:10.1016/j.jcf.2009.11.010

« Previous Next »Journal of Cystic Fibrosis
Volume 9, Issue 2 , Pages 110-116, March 2010

Prevalence and risk factors for recovery of filamentous fungi in individuals with cystic fibrosis

Christopher R. Sudfeld
- The Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, 6th Floor, Baltimore, MD 21205, United States
- Corresponding author. 615 N Wolfe Street, 6th Floor, Baltimore, MD 21205, United States.
Elliott C. Dasenbrook
- The Johns Hopkins University School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, 1830 E. Monument Street, 5th Floor, Baltimore, MD 21205, United States
William G. Merz
- The Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N. Wolfe Street, 6th Floor, Baltimore, MD 21205, United States
- The Johns Hopkins Medical Institutions, Department of Pathology, Division of Microbiology, 600 N. Wolfe S, Meyer B1-193, Baltimore, MD 21287, United States
Karen C. Carroll
- The Johns Hopkins Medical Institutions, Department of Pathology, Division of Microbiology, 600 N. Wolfe S, Meyer B1-193, Baltimore, MD 21287, United States
Michael P. Boyle
- The Johns Hopkins University School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, 1830 E. Monument Street, 5th Floor, Baltimore, MD 21205, United States

Received 3 October 2009; received in revised form 29 November 2009; accepted 30 November 2009.

Abstract

Background

Filamentous fungi are frequently recovered from respiratory cultures of individuals with CF.

Methods

A CF cohort database was utilized to determine filamentous fungal prevalence and risk factors.

Results

The prevalence of filamentous fungal isolation increased from 2.0% in 1997 to 28.7% in 2007. The odds of isolating filamentous fungi during a quarter was greater in CF adults [p<0.001], during chronic oral antibiotic use [p=0.002] and increased with each 10% drop in FEV₁ percent predicted [p=0.005], while inhaled corticosteroids surprisingly decreased the likelihood [p=0.012]. The direction of these effects persisted after excluding individuals with ABPA. A sub-analysis determined older age [p=0.019] and use of inhaled antibiotics [p=0.011] were independent risk factors for onset of fungal colonization.

Conclusions

This study suggests that isolation of filamentous fungi in CF at JHH has increased and risk factors include older age, decreased lung function, and chronic oral antibiotics.

Keywords: Cystic fibrosis, Filamentous fungi, Prevalence, Corticosteroids