title: High rate of Exophiala dermatitidis recovery in the airways of patients with cystic fibrosis is associated with pancreatic insufficiency.
abstract: The black-pigmented fungus Exophiala dermatitidis is considered to be a harmless colonizer of the airways of cystic fibrosis (CF) patients. The aim of this study was to establish the recovery rate of E. dermatitidis in respiratory specimens from CF patients, transplant recipients, and subjects with other respiratory disorders in Sweden. Second, we wished to determine if particular clinical traits were associated with E. dermatitidis colonization of the airways and the antifungal susceptibility profiles of Exophiala strains. Sputum and bronchoalveolar lavage samples (n = 492) derived from 275 patients were investigated. E. dermatitidis was isolated in respiratory specimens from 19% (18/97) of the CF patients but in none of the other patient categories. All isolates were recovered after 6 to 25 days of incubation on erythritol-chloramphenicol agar (ECA) medium. Morphological and genetic analyses confirmed species identity. Pancreatic insufficiency was positively associated with the presence of E. dermatitidis in sputum samples (P = 0.0198). Antifungal susceptibility tests demonstrated that voriconazole and posaconazole had the lowest MICs against E. dermatitidis. In conclusion, E. dermatitidis is a frequent colonizer of the respiratory tract in CF patients in Sweden and appears to be associated with more advanced disease. Whether E. dermatitidis is pathogenic remains to be elucidated.
authors.affiliation: Department of Clinical Bacteriology, Sahlgrenska University Hospital, 40234 Gothenburg, Sweden. nahid.kondori@microbio.gu.se
authors.forename: Nahid
authors.initials: N
authors.lastname: Kondori
authors.forename: Marita
authors.initials: M
authors.lastname: Gilljam
authors.forename: Anders
authors.initials: A
authors.lastname: Lindblad
authors.forename: Bodil
authors.initials: B
authors.lastname: Jönsson
authors.forename: Edward R B
authors.initials: ER
authors.lastname: Moore
authors.forename: Christine
authors.initials: C
authors.lastname: Wennerås
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D002353:Carrier State / Q000382:microbiology*; D003550:Cystic Fibrosis / Q000150:complications*; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications*; D005093:Exophiala / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009181:Mycoses / Q000382:microbiology; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000382:microbiology*; D013183:Sputum / Q000382:microbiology; D013548:Sweden; D055815:Young Adult
chemical_list: D000935:Antifungal Agents