BACKGROUND: The role of Candida albicans in the cystic fibrosis (CF) airway is underexplored. Considered a colonizer, few question its pathogenic potential despite high isolation frequencies from sputum culture. We evaluated the frequency and identified the strongest predictors of C albicans colonization in CF. Independent associations of colonization with clinical outcomes were determined, and the longitudinal effects of C albicans acquisition on BMI and FEV₁ were evaluated. METHODS: A prospective observational study of 89 patients with CF was performed (3,916 sputum samples over 11 years). Frequency of C albicans growth in sputum allowed classification of the cohort into colonizers and noncolonizers. BMI, FEV₁, hospital-treated exacerbations, and other clinical parameters were followed throughout the study to determine association with colonization status. Multivariate regression determined the strongest predictors of colonization and for clinical effects after adjustment for confounders. Repeated-measures analysis of variance assessed the longitudinal effect of colonization on BMI and FEV₁. RESULTS: Colonization with C albicans was frequent (49.4%) and best predicted by pancreatic insufficiency (P = .014), osteopenia (P = .03), and cocolonization with Pseudomonas species (P = .002). C albicans colonization significantly predicted hospital-treated exacerbations (P = .004) after adjustment for confounders. Exacerbation rate significantly increased in patients with chronic or intermittent colonizations following first acquisition of C albicans. Colonization accelerated rates of decline for BMI (P < .0001) and FEV₁ (P < .001). CONCLUSION: Airway colonization with C albicans presaged a greater rate of FEV₁ decline and hospital-treated exacerbations in CF.
BACKGROUND: The role of Candida albicans in the cystic fibrosis (CF) airway is underexplored. Considered a colonizer, few question its pathogenic potential despite high isolation frequencies from sputum culture. We evaluated the frequency and identified the strongest predictors of C albicans colonization in CF. Independent associations of colonization with clinical outcomes were determined, and the longitudinal effects of C albicans acquisition on BMI and FEV₁ were evaluated. METHODS: A prospective observational study of 89 patients with CF was performed (3,916 sputum samples over 11 years). Frequency of C albicans growth in sputum allowed classification of the cohort into colonizers and noncolonizers. BMI, FEV₁, hospital-treated exacerbations, and other clinical parameters were followed throughout the study to determine association with colonization status. Multivariate regression determined the strongest predictors of colonization and for clinical effects after adjustment for confounders. Repeated-measures analysis of variance assessed the longitudinal effect of colonization on BMI and FEV₁. RESULTS: Colonization with C albicans was frequent (49.4%) and best predicted by pancreatic insufficiency (P = .014), osteopenia (P = .03), and cocolonization with Pseudomonas species (P = .002). C albicans colonization significantly predicted hospital-treated exacerbations (P = .004) after adjustment for confounders. Exacerbation rate significantly increased in patients with chronic or intermittent colonizations following first acquisition of C albicans. Colonization accelerated rates of decline for BMI (P < .0001) and FEV₁ (P < .001). CONCLUSION: Airway colonization with C albicans presaged a greater rate of FEV₁ decline and hospital-treated exacerbations in CF.
Authors: C Staerck; P Vandeputte; A Gastebois; A Calenda; S Giraud; N Papon; J P Bouchara; M J J Fleury Journal: Mycopathologia Date: 2017-06-21 Impact factor: 2.574
Authors: Micheál Mac Aogáin; Jayanth Kumar Narayana; Pei Yee Tiew; Nur A'tikah Binte Mohamed Ali; Valerie Fei Lee Yong; Tavleen Kaur Jaggi; Albert Yick Hou Lim; Holly R Keir; Alison J Dicker; Kai Xian Thng; Akina Tsang; Fransiskus Xaverius Ivan; Mau Ern Poh; Martina Oriano; Stefano Aliberti; Francesco Blasi; Teck Boon Low; Thun How Ong; Brian Oliver; Yan Hui Giam; Augustine Tee; Mariko Siyue Koh; John Arputhan Abisheganaden; Krasimira Tsaneva-Atanasova; James D Chalmers; Sanjay H Chotirmall Journal: Nat Med Date: 2021-04-05 Impact factor: 53.440
Authors: Pei Yee Tiew; Micheál Mac Aogáin; Soo Kai Ter; Stefano Aliberti; James D Chalmers; Sanjay H Chotirmall Journal: Mycopathologia Date: 2021-03-11 Impact factor: 2.574