title: Association of chronic Candida albicans respiratory infection with a more severe lung disease in patients with cystic fibrosis.
abstract: BACKGROUND
  Despite the increase in fungal isolates, the significance of chronic Candida albicans airway colonization in CF is unclear.
  
  
  OBJECTIVE
  To investigate the impact of C. albicans airway colonization on CF disease severity.
  
  
  METHODS
  Longitudinal analysis of clinical data from CF patients followed during 2003-2009 at our CF center. Patients were stratified based on their C. albicans colonization status--chronic, intermittent, and none.
  
  
  RESULTS
  A total of 4,244 cultures were obtained from 91 patients (mean age 19.7 years, range 5-68). The three colonization groups were similar in age, gender,and body mass index (BMI). Compared to the non-colonized group (n = 27, 30%), the chronic C. albicans colonization group (n = 34, 37%), had a significantly lower FEV1 percent predicted (74.3 ± 23.1% vs. 93.9% ± 22.2) with a higher annual rate of FEV1 decline (-1.9 ± 4.2% vs. 0.7 ± 4.5%). The patients who were intermittently colonized with C. albicans had intermediate values.
  
  
  CONCLUSIONS
  Chronic respiratory colonization of C. albicans is associated with worsening of FEV1 in CF. Prospective studies are needed to confirm this finding and to corroborate whether indeed C. albicans drives a deleterious lung phenotype.
authors.affiliation: Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.
authors.forename: Alex
authors.initials: A
authors.lastname: Gileles-Hillel
authors.affiliation: Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.|Pediatric Pulmonology Unit, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.|Cystic Fibrosis Center, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Shoseyov
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.
authors.forename: Itzhack
authors.initials: I
authors.lastname: Polacheck
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.
authors.forename: Maya
authors.initials: M
authors.lastname: Korem
authors.affiliation: Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.|Pediatric Pulmonology Unit, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.|Cystic Fibrosis Center, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.
authors.forename: Eitan
authors.initials: E
authors.lastname: Kerem
authors.affiliation: Department of Pediatrics, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.|Pediatric Pulmonology Unit, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.|Cystic Fibrosis Center, Hadassah Hebrew-University Medical Center, Jerusalem, Israel.
authors.forename: Malena
authors.initials: M
authors.lastname: Cohen-Cymberknoh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000382:microbiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Cystic fibrosis; disease progression; forced expiratory volume/physiology; sputum/microbiology