Prevalence and factors associated with isolation of Aspergillus and Candida from sputum in patients with non-cystic fibrosis bronchiectasis.
BACKGROUND
Information on the role of fungi in non-cystic fibrosis (CF) bronchiectasis is lacking.


OBJECTIVE
Our aim was to determine the prevalence of and factors associated with the isolation and persistence of fungi from sputum in these patients.


METHODS
We performed a multicenter observational study comprising adult patients with non-CF bronchiectasis. Persistence of Aspergillus spp. and Candida albicans was defined as the presence of ≥2 positive sputum cultures taken at least 6 months apart within a period of 5 years.


RESULTS
A total of 252 patients (62.7% women with a mean ± SD age of 55.3 ± 16.7 years) were included in the study. All patients had at least 1 sputum sample cultured for fungi, with a mean ± SD of 7 ± 6 cultures per patient. Eighteen (8.7%) and 71 (34.5%) patients had persistent positive cultures for Aspergillus spp. and C. albicans, respectively. Patients with persistence of Aspergillus spp. and C. albicans were older and had more daily purulent sputum. In addition, patients with persistent C. albicans had worse postbronchodilator forced expiratory volume in the first second (FEV1), more frequent cystic bronchiectasis, and more hospital-treated exacerbations. They were also more frequently treated with long-term antibiotics. Multivariate analysis showed that daily purulent sputum (OR = 3.75, p = 0.045) and long-term antibiotics (OR = 2.37, p = 0.005) were independently associated with persistence of Aspergillus spp. and C. albicans, respectively.


CONCLUSIONS
Isolation and persistence of Aspergillus spp. and C. albicans are frequent in patients with non-CF bronchiectasis. Daily purulent sputum and chronic antibiotic treatment were associated with persistence of Aspergillus spp. and C. albicans, respectively.
Pneumology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Luis
L
Máiz
Montserrat
M
Vendrell
Casilda
C
Olveira
Rosa
R
Girón
Rosa
R
Nieto
Miguel Ángel
MÁ
Martínez-García
D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001230:Aspergillus / Q000302:isolation & purification*; D001987:Bronchiectasis / Q000382:microbiology*; D002175:Candida / Q000302:isolation & purification*; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013183:Sputum / Q000382:microbiology*
D000900:Anti-Bacterial Agents