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Med Mycol. 2014 Oct;52(7):715-22. doi: 10.1093/mmy/myu038. Epub 2014 Jul 23.

Inhaled corticosteroids and Aspergillus fumigatus isolation in cystic fibrosis.

Author information

1
Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, Medical School, University of Athens, Athens, Greece marianoni21@gmail.com.
2
Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, Medical School, University of Athens, Athens, Greece.
3
Department of Critical Care, University Hospital "Attikon," Medical School, University of Athens, Athens, Greece.
4
Department of Infectious Diseases, "Aghia Sophia" Children's Hospital, Athens, Greece.
5
Department of Microbiology, "Aghia Sophia" Children's Hospital, Athens, Greece.
6
Department of Pediatrics, "P & A Kyriakou" Children's Hospital, Medical School, University of Athens, Athens, Greece.

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.

KEYWORDS:

Aspergillus fumigatus; cystic fibrosis; inhaled corticosteroids

PMID:
25056962
DOI:
10.1093/mmy/myu038
[Indexed for MEDLINE]

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