Thibaud Soumagne1, Gabriel Reboux2, Flora Metzger3, Sandrine Roussel4, Annick Lefebvre5, Emmanuelle Penven6, Paul De Vuyst7, Isabelle Thaon8, Jean-Charles Dalphin9. 1. Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, Besançon, France; Service de Physiologie-Explorations Fonctionnelles, Centre Hospitalier Universitaire de Besançon, Besançon, France. Electronic address: thibaud_soumagne@live.fr. 2. UMR-CNRS 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France; Laboratoire de Mycologie, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France. 3. Service de Pneumologie, Centre Hospitalier de Colmar, Colmar, France. 4. UMR-CNRS 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France. 5. Service d'Hygiène Hospitalière, Centre Hospitalier Universitaire de Reims, Reims, France. 6. Université de Lorraine, CHRU-Nancy, Centre de Consultations de Pathologies Professionnelles, Nancy, France. 7. Service de Pneumologie, Université Libre de Bruxelles, Brussels, Belgium. 8. Université de Lorraine, CHRU-Nancy, Centre de Consultations de Pathologies Professionnelles, Nancy, France; Université de Lorraine, APEMAC, Nancy, France. 9. Service de Pneumologie, Centre Hospitalier Universitaire de Besançon, Besançon, France; UMR-CNRS 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France.
Abstract
INTRODUCTION: Playing a wind instrument is an increasingly reported cause of hypersensitivity pneumonitis. However, current knowledge about contamination of wind instruments by fungi and specific fungal sensitization is scarce. Therefore, we aimed: (i) to assess the current prevalence and type of fungal contamination of wind instruments, (ii) to identify potential risk factors associated with instrument contamination, and (iii) to evaluate the prevalence of sensitization to these fungi among musicians. MATERIAL AND METHODS: Musicians from music schools in eastern France and who played a wind instrument were prospectively recruited (NCT01487850). The mouthpiece and the reed of their instrument were sampled to quantify the magnitude and type of fungi. Each subject had a physical examination, a mycological analysis of saliva and a blood sample in search of serum precipitins against the most frequent fungi isolated from instruments. The results were compared with those of 40 healthy non-exposed controls. RESULTS: Forty musicians playing a wind instrument (bassoon, clarinet, oboe, saxophone) were included. (i) 95% of wind instruments were colonized by fungi, mainly with Phoma spp., Penicillium spp. and Rhodotorula mucilaginosa; (ii) absence of systematic drying of the instrument was a main contributing factor; (iii) serum precipitins were significantly more present in the musicians' sera than in control sera and were consistent with the fungi present in their instrument. CONCLUSION: This study reveals a constant and specific fungal contamination among wind reed instruments with a significant sensitization among musicians, pleading in favour of regular instrument cleaning. Physicians should be aware of this possible source of antigenic exposure.
INTRODUCTION: Playing a wind instrument is an increasingly reported cause of hypersensitivitypneumonitis. However, current knowledge about contamination of wind instruments by fungi and specific fungal sensitization is scarce. Therefore, we aimed: (i) to assess the current prevalence and type of fungal contamination of wind instruments, (ii) to identify potential risk factors associated with instrument contamination, and (iii) to evaluate the prevalence of sensitization to these fungi among musicians. MATERIAL AND METHODS: Musicians from music schools in eastern France and who played a wind instrument were prospectively recruited (NCT01487850). The mouthpiece and the reed of their instrument were sampled to quantify the magnitude and type of fungi. Each subject had a physical examination, a mycological analysis of saliva and a blood sample in search of serum precipitins against the most frequent fungi isolated from instruments. The results were compared with those of 40 healthy non-exposed controls. RESULTS: Forty musicians playing a wind instrument (bassoon, clarinet, oboe, saxophone) were included. (i) 95% of wind instruments were colonized by fungi, mainly with Phoma spp., Penicillium spp. and Rhodotorula mucilaginosa; (ii) absence of systematic drying of the instrument was a main contributing factor; (iii) serum precipitins were significantly more present in the musicians' sera than in control sera and were consistent with the fungi present in their instrument. CONCLUSION: This study reveals a constant and specific fungal contamination among wind reed instruments with a significant sensitization among musicians, pleading in favour of regular instrument cleaning. Physicians should be aware of this possible source of antigenic exposure.
Authors: Kerri A Johannson; Hayley Barnes; Anne-Pauline Bellanger; Jean-Charles Dalphin; Evans R Fernández Pérez; Kevin R Flaherty; Yuh-Chin T Huang; Kirk D Jones; Leticia Kawano-Dourado; Kevin Kennedy; Melissa Millerick-May; Yasunari Miyazaki; Julie Morisset; Ferran Morell; Ganesh R Raghu; Coreen Robbins; Coralynn S Sack; Margaret L Salisbury; Moises Selman; Martina Vasakova; Simon L F Walsh; Cecile S Rose Journal: Ann Am Thorac Soc Date: 2020-12