Persistent Aspergillus fumigatus infection in cystic fibrosis : impact on lung function and role of treatment of asymptomatic colonization-a registry-based case-control study
(2022) In BMC Pulmonary Medicine 22(1).- Abstract
BACKGROUND: Aspergillus fumigatus is the most common filamentous fungus isolated from the airways of people with cystic fibrosis (CF). The aim of this study was to investigate how chronic A. fumigatus colonization affects lung function in people with CF, to identify risk factors for colonization, and to evaluate antifungal treatment of asymptomatic Aspergillus colonization.
METHODS: Data from 2014-2018 was collected from the Swedish CF registry and medical records. Baseline data before the start of A. fumigatus colonization was compared with the two succeeding years to evaluate how colonization and treatment affected lung function and other clinical aspects.
RESULTS: A total of 437 patients were included, of which 64 (14.6%)... (More)
BACKGROUND: Aspergillus fumigatus is the most common filamentous fungus isolated from the airways of people with cystic fibrosis (CF). The aim of this study was to investigate how chronic A. fumigatus colonization affects lung function in people with CF, to identify risk factors for colonization, and to evaluate antifungal treatment of asymptomatic Aspergillus colonization.
METHODS: Data from 2014-2018 was collected from the Swedish CF registry and medical records. Baseline data before the start of A. fumigatus colonization was compared with the two succeeding years to evaluate how colonization and treatment affected lung function and other clinical aspects.
RESULTS: A total of 437 patients were included, of which 64 (14.6%) became colonized with A. fumigatus during the study period. Inhaled antibiotics was associated with A. fumigatus colonization (adjusted OR 3.1, 95% CI 1.6-5.9, p < 0.05). Fungal colonization was not associated with a more rapid lung function decline or increased use of IV-antibiotics compared to the non-colonized group, but patients with A. fumigatus had more hospital days, a higher increase of total IgE, and higher eosinophil counts. In the Aspergillus group, 42 patients were considered to be asymptomatic. Of these, 19 patients received antifungal treatment. Over the follow up period, the treated group had a more pronounced decrease in percent predicted Forced Expiratory Volume in one second (ppFEV1) compared to untreated patients (- 8.7 vs - 1.4 percentage points, p < 0.05).
CONCLUSION: Inhaled antibiotics was associated with A. fumigatus colonization, but no association was found between persistent A. fumigatus and subsequent lung function decline. No obvious benefits of treating asymptomatic A. fumigatus colonization were demonstrated.
(Less)
- author
- Blomquist, Axel LU ; Inghammar, Malin LU ; Al Shakirchi, Mahasin ; Ericson, Petrea ; Krantz, Christina ; Svedberg, Marcus ; Lindblad, Anders and Påhlman, Lisa I LU
- organization
- publishing date
- 2022-07-05
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Anti-Bacterial Agents/therapeutic use, Antifungal Agents/therapeutic use, Aspergillus fumigatus, Asymptomatic Infections, Case-Control Studies, Cystic Fibrosis/complications, Humans, Lung, Persistent Infection, Registries
- in
- BMC Pulmonary Medicine
- volume
- 22
- issue
- 1
- article number
- 263
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:35790954
- scopus:85133496404
- ISSN
- 1471-2466
- DOI
- 10.1186/s12890-022-02054-3
- language
- English
- LU publication?
- yes
- additional info
- © 2022. The Author(s).
- id
- 70ee8cef-85d6-4a1a-b574-c62a9f919da5
- date added to LUP
- 2022-09-17 14:17:04
- date last changed
- 2024-06-13 13:32:16
@article{70ee8cef-85d6-4a1a-b574-c62a9f919da5,
abstract = {{<p>BACKGROUND: Aspergillus fumigatus is the most common filamentous fungus isolated from the airways of people with cystic fibrosis (CF). The aim of this study was to investigate how chronic A. fumigatus colonization affects lung function in people with CF, to identify risk factors for colonization, and to evaluate antifungal treatment of asymptomatic Aspergillus colonization.</p><p>METHODS: Data from 2014-2018 was collected from the Swedish CF registry and medical records. Baseline data before the start of A. fumigatus colonization was compared with the two succeeding years to evaluate how colonization and treatment affected lung function and other clinical aspects.</p><p>RESULTS: A total of 437 patients were included, of which 64 (14.6%) became colonized with A. fumigatus during the study period. Inhaled antibiotics was associated with A. fumigatus colonization (adjusted OR 3.1, 95% CI 1.6-5.9, p < 0.05). Fungal colonization was not associated with a more rapid lung function decline or increased use of IV-antibiotics compared to the non-colonized group, but patients with A. fumigatus had more hospital days, a higher increase of total IgE, and higher eosinophil counts. In the Aspergillus group, 42 patients were considered to be asymptomatic. Of these, 19 patients received antifungal treatment. Over the follow up period, the treated group had a more pronounced decrease in percent predicted Forced Expiratory Volume in one second (ppFEV1) compared to untreated patients (- 8.7 vs - 1.4 percentage points, p < 0.05).</p><p>CONCLUSION: Inhaled antibiotics was associated with A. fumigatus colonization, but no association was found between persistent A. fumigatus and subsequent lung function decline. No obvious benefits of treating asymptomatic A. fumigatus colonization were demonstrated.</p>}},
author = {{Blomquist, Axel and Inghammar, Malin and Al Shakirchi, Mahasin and Ericson, Petrea and Krantz, Christina and Svedberg, Marcus and Lindblad, Anders and Påhlman, Lisa I}},
issn = {{1471-2466}},
keywords = {{Anti-Bacterial Agents/therapeutic use; Antifungal Agents/therapeutic use; Aspergillus fumigatus; Asymptomatic Infections; Case-Control Studies; Cystic Fibrosis/complications; Humans; Lung; Persistent Infection; Registries}},
language = {{eng}},
month = {{07}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Pulmonary Medicine}},
title = {{Persistent Aspergillus fumigatus infection in cystic fibrosis : impact on lung function and role of treatment of asymptomatic colonization-a registry-based case-control study}},
url = {{http://dx.doi.org/10.1186/s12890-022-02054-3}},
doi = {{10.1186/s12890-022-02054-3}},
volume = {{22}},
year = {{2022}},
}