Infectious complications of lung transplantation. Impact of cystic fibrosis
Flume PA, Egan TM, Paradowski LJ, Detterbeck FC, Thompson JT, Yankaskas JR
Background: Moulds are frequently recovered from respiratory samples of cystic fibrosis (CF) patients. During the last decade, antifungal resistance in non-Candida species is increasingly reported. Azole resistance in Aspergillus fumigatus is a well-known problem and it was firstly reported in 1997 in three itraconazole-resistant clinical isolates. Since then, the main azole resistance mechanism reported are mutations at the CYP51A gene which encodes the azole drug target, the 14- α-sterol demethylase.
Understanding the composition and clinical importance of the fungal mycobiome was recently identified as a key topic in a "research priorities" consensus statement for bronchiectasis. Patients were recruited as part of the CAMEB study: an international multicentre cross-sectional Cohort of Asian and Matched European Bronchiectasis patients. The mycobiome was determined in 238 patients by targeted amplicon shotgun sequencing of the 18S–28S rRNA internally transcribed spacer regions ITS1 and ITS2. Specific quantitative PCR for detection of and conidial quantification for a range of airway Aspergillus species ...
Interactions in the airway ecology of cystic fibrosis may alter organism persistence and clinical outcomes. Better understanding of such interactions could guide clinical decisions. We used generalized estimating equations to fit logistic regression models to longitudinal 2-year patient cohorts in the Cystic Fibrosis Foundation Patient Registry, 2003 to 2011, in order to study associations between the airway organisms present in each calendar year and their presence in the subsequent year. Models were adjusted for clinical characteristics and multiple observations per patient. Adjusted models were tested for sensitivity to...
Wednesday, July 18, 2018 - 13:02Slide presentation
CONCLUSION: A 13-year old patient with CF was successfully treated for an A. fumigatus infection with posaconazole delayed-release tablets. PMID: 29941535 [PubMed - in process]
The pulmonary mucus of cystic fibrosis (CF) patients displays elevated levels of the cathelicidin antimicrobial peptide LL-37, and the aim of this work was to assess the effect of LL-37 on the growth of Aspergillus fumigatus, a common pathogen of CF patients. Exposure of A. fumigatus to LL-37 and its derived fragment RK-31 (1.95 μg/ml) for 24 h had a positive effect on growth (199.94% ± 6.172% [P
Abstract Scedosporium spp. cause infections (scedosporiosis) in both immunocompetent and immunocompromised individuals and may persistently colonise the respiratory tract in patients with cystic fibrosis (CF). They are less susceptible against azoles when compared with other moulds such as Aspergillus, suggesting the presence of resistance mechanisms. It can be hypothesised that the decreased susceptibility of Scedosporium spp. to azoles is also CYP51 dependant. Analysis of the S. apiospermum and S. aurantiacum genome revealed one CYP51 gene encoding the 14 alpha-lanosterol demethylase. This gene of 159 clinical o...