Prevalence and risk factors for recovery of filamentous fungi in individuals with cystic fibrosis.
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 FEV(1) 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.
Sudfeld
Christopher R
CR
Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, 6th Floor, Baltimore, MD 21205, United States. crsudfeld@gmail.com
Dasenbrook
Elliott C
EC
Merz
William G
WG
Carroll
Karen C
KC
Boyle
Michael P
MP
D000280:Administration, Inhalation; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000188:drug therapy / Q000382:microbiology* / Q000503:physiopathology; D016208:Databases, Factual; D004334:Drug Administration Schedule; D005541:Forced Expiratory Volume; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D009181:Mycoses / Q000150:complications* / Q000453:epidemiology*; D015995:Prevalence; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents