title: Inhaled corticosteroids and Aspergillus fumigatus isolation in cystic fibrosis.
abstract: Aspergillus fumigatus isolation in cultures from respiratory specimens of patients with cystic fibrosis (CF) is quite common; however, the role of A. fumigatus as a pathogen and whether its presence is associated with progression of pulmonary disease remain unclear. We investigated the association between inhaled corticosteroids and the recovery of A. fumigatus by performing a retrospective cohort study of CF patients born between 1988 and 1996. The patients' medical records from their first visit to the CF Center until December 2010 were reviewed. Outcomes were the occurrence of A. fumigatus first isolation, chronic colonization, or the last visit at the CF Center. A number of possible confounders were included in the multivariate logistic regression analysis in order to identify an independent association between inhaled corticosteroids and colonization status. A total of 121 patients were included in the study. Thirty-nine patients (32.2%) had at least one positive culture and 14 (11.6%) developed chronic colonization. Multivariate logistic regression analysis was used to determine the independent effect of inhaled corticosteroids on the odds of first isolation (odds ratio [OR], 1.165; 95% confidence interval [CI], 1.015-1.337; P = 0.029) and chronic colonization (OR, 1.180; 95% CI, 1.029-1.353; P = 0.018). In conclusion, A. fumigatus first isolation and chronic colonization are associated with the duration of inhaled corticosteroid treatment.
authors: Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, Medical School, University of Athens, Athens, Greece marianoni21@gmail.com.
authors: Maria
authors: M
authors: Noni
authors: Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, Medical School, University of Athens, Athens, Greece.
authors: Anna
authors: A
authors: Katelari
authors: Department of Critical Care, University Hospital "Attikon," Medical School, University of Athens, Athens, Greece.
authors: George
authors: G
authors: Dimopoulos
authors: Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, Medical School, University of Athens, Athens, Greece.
authors: Georgia
authors: G
authors: Kourlaba
authors: Department of Infectious Diseases, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors: Vana
authors: V
authors: Spoulou
authors: Department of Microbiology, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors: Helen
authors: H
authors: Alexandrou-Athanassoulis
authors: Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, Medical School, University of Athens, Athens, Greece.
authors: Stavros-Eleftherios
authors: SE
authors: Doudounakis
authors: Department of Pediatrics, "P & A Kyriakou" Children's Hospital, Medical School, University of Athens, Athens, Greece.
authors: Chryssa
authors: C
authors: Tzoumaka-Bakoula
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D015233:Models, Statistical; D055732:Pulmonary Aspergillosis / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents
keywords: Aspergillus fumigatus; cystic fibrosis; inhaled corticosteroids