INHALED ANTIBIOTIC USE IS ASSOCIATED WITH SCEDOSPORIUM/LOMENTOSPORA SPECIES ISOLATION IN CYSTIC FIBROSIS

Authors:
Hong G, Lechtzin N, Hadjiliadis D, Kawut S

 

What was your research question?
We wanted to better understand what factors may be contributing to the rise of fungal colonization/infections in patients with cystic fibrosis (CF). In particular, we looked at a fungus known as Scedosporium species.

Why is this important?
Over the past twenty years there has been an increase of fungal colonizations/infections in the CF population and Scedosporium species is the second most common mold seen in the CF lung. We do not fully understand the direct causes or effects of finding Scedosporium on cultures.

What did you do?
We studied individuals with CF who were 6 years and older in the CF Foundation Patient Registry between January 1, 2010 and December 31, 2012. We identified the individuals who had a positive culture for Scedosporium and compared their characteristics to see if they shared anything in common. People who had a history of lung or liver transplant were not included.

What did you find?
The study found Scedosporium species in approximately 3% of the United States CF population. Older patients and Caucasian individuals were more likely to have a positive Scedosporium culture. In addition, people who were prescribed an inhaled antibiotic, such as tobramycin or aztreonam, were more likely to have a positive Scedosporium culture.

What does this mean and reasons for caution?
The association between inhaled antibiotics and Scedosporium informs us that chronic inhaled antibiotics may be playing a role in Scedosporium colonization/infection. However, we cannot conclude that inhaled antibiotics are directly causing Scedosporium colonization/infection. It is plausible that we are seeing Scedosporium in sicker people who happen to be on inhaled antibiotics. Further investigation to better characterize this relationship is necessary.

What’s next?
We need to see the clinical impact that Scedosporium has on CF patients.

 

Original citation:
Pediatr Pulmonol. 2019 Feb;54(2):133-140.



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