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Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors

BACKGROUND: An increasing rate of respiratory colonization and infection in cystic fibrosis (CF) is caused by fungi of the Scedosporium apiospermum species complex or Lomentospora prolificans (Sac-Lp). These fungi rank second among the filamentous fungi colonizing the CF airways, after Aspergillus f...

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Autores principales: Schwarz, Carsten, Brandt, Claudia, Antweiler, Elisabeth, Krannich, Alexander, Staab, Doris, Schmitt-Grohé, Sabina, Fischer, Rainald, Hartl, Dominik, Thronicke, Anja, Tintelnot, Kathrin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5298894/
https://www.ncbi.nlm.nih.gov/pubmed/28178337
http://dx.doi.org/10.1371/journal.pone.0171485
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author Schwarz, Carsten
Brandt, Claudia
Antweiler, Elisabeth
Krannich, Alexander
Staab, Doris
Schmitt-Grohé, Sabina
Fischer, Rainald
Hartl, Dominik
Thronicke, Anja
Tintelnot, Kathrin
author_facet Schwarz, Carsten
Brandt, Claudia
Antweiler, Elisabeth
Krannich, Alexander
Staab, Doris
Schmitt-Grohé, Sabina
Fischer, Rainald
Hartl, Dominik
Thronicke, Anja
Tintelnot, Kathrin
author_sort Schwarz, Carsten
collection PubMed
description BACKGROUND: An increasing rate of respiratory colonization and infection in cystic fibrosis (CF) is caused by fungi of the Scedosporium apiospermum species complex or Lomentospora prolificans (Sac-Lp). These fungi rank second among the filamentous fungi colonizing the CF airways, after Aspergillus fumigatus. However, the epidemiology, clinical relevance and risk of pulmonary colonization with Sac-Lp are rarely understood in CF. The objective of the present prospective multicenter study was to study pathogen distribution and determine association factors of pulmonary Sac-Lp colonization in patients with CF. MATERIAL AND METHODS: Clinical, microbiological and laboratory data of 161 patients aged 6–59 years with CF in Germany were analyzed for Sac-Lp distribution and association factors. The free statistical software R was utilized to investigate adjusted logistic regression models for association factors. RESULTS: Of the 161 patients included in the study, 74 (56%) were male. The median age of the study cohort was 23 years (interquartile range 13–32 years). 58 patients of the total cohort (36%) were < 18 years old. Adjusted multivariate regression analysis revealed that Sac-Lp colonization was associated with younger age (OR 0.8684, 95%CI: 0.7955–0.9480, p<0.005) and less colonization with H. influenzae (OR 0.0118, 95%CI: 0.0009–0.1585, p<0.001). In addition, Sac-Lp-colonized patients had more often allergic bronchopulmonary aspergillosis (ABPA) (OR 14.6663, 95%CI: 2.1873–98.3403, p<0.01) and have been colonized more often with the mucoid phenotype of Pseudomonas aeruginosa (OR 9.8941, 95%CI: 1.0518–93.0705, p<0.05). CONCLUSION: Newly found association of ABPA and Pseudomonas revealed new probable risk factors for Sac-Lp colonization. Allergy might play a role in inducing immunologic host reactions which lead to a less effective response to species of Sac-Lp.
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spelling pubmed-52988942017-02-17 Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors Schwarz, Carsten Brandt, Claudia Antweiler, Elisabeth Krannich, Alexander Staab, Doris Schmitt-Grohé, Sabina Fischer, Rainald Hartl, Dominik Thronicke, Anja Tintelnot, Kathrin PLoS One Research Article BACKGROUND: An increasing rate of respiratory colonization and infection in cystic fibrosis (CF) is caused by fungi of the Scedosporium apiospermum species complex or Lomentospora prolificans (Sac-Lp). These fungi rank second among the filamentous fungi colonizing the CF airways, after Aspergillus fumigatus. However, the epidemiology, clinical relevance and risk of pulmonary colonization with Sac-Lp are rarely understood in CF. The objective of the present prospective multicenter study was to study pathogen distribution and determine association factors of pulmonary Sac-Lp colonization in patients with CF. MATERIAL AND METHODS: Clinical, microbiological and laboratory data of 161 patients aged 6–59 years with CF in Germany were analyzed for Sac-Lp distribution and association factors. The free statistical software R was utilized to investigate adjusted logistic regression models for association factors. RESULTS: Of the 161 patients included in the study, 74 (56%) were male. The median age of the study cohort was 23 years (interquartile range 13–32 years). 58 patients of the total cohort (36%) were < 18 years old. Adjusted multivariate regression analysis revealed that Sac-Lp colonization was associated with younger age (OR 0.8684, 95%CI: 0.7955–0.9480, p<0.005) and less colonization with H. influenzae (OR 0.0118, 95%CI: 0.0009–0.1585, p<0.001). In addition, Sac-Lp-colonized patients had more often allergic bronchopulmonary aspergillosis (ABPA) (OR 14.6663, 95%CI: 2.1873–98.3403, p<0.01) and have been colonized more often with the mucoid phenotype of Pseudomonas aeruginosa (OR 9.8941, 95%CI: 1.0518–93.0705, p<0.05). CONCLUSION: Newly found association of ABPA and Pseudomonas revealed new probable risk factors for Sac-Lp colonization. Allergy might play a role in inducing immunologic host reactions which lead to a less effective response to species of Sac-Lp. Public Library of Science 2017-02-08 /pmc/articles/PMC5298894/ /pubmed/28178337 http://dx.doi.org/10.1371/journal.pone.0171485 Text en © 2017 Schwarz et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schwarz, Carsten
Brandt, Claudia
Antweiler, Elisabeth
Krannich, Alexander
Staab, Doris
Schmitt-Grohé, Sabina
Fischer, Rainald
Hartl, Dominik
Thronicke, Anja
Tintelnot, Kathrin
Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors
title Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors
title_full Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors
title_fullStr Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors
title_full_unstemmed Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors
title_short Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors
title_sort prospective multicenter german study on pulmonary colonization with scedosporium /lomentospora species in cystic fibrosis: epidemiology and new association factors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5298894/
https://www.ncbi.nlm.nih.gov/pubmed/28178337
http://dx.doi.org/10.1371/journal.pone.0171485
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