Abstract
Aims: The presence of fungi in the airways of patients with cystic fibrosis (CF) is common, the most prevalent species being Aspergillus and Candida. However, it is unknown its role in the disease. The aim is to describe the changes over time of fungal microbiota and evaluate the clinical aspects related to them
Methods: Prospective observational cohort study including children and adults with CF. Clinical and functional data and a sample of sputum at baseline and at 6 months were collected. The microbiological study was performed in sputum with conventional culture and a metagenomics approach using nested polymerase chain reaction and direct sequencing. The prevalence of fungal colonization by both techniques and the relationship with clinical variables of patients and their evolution are analysed
Results: 63 CF patients were included, 46 adults and 17 children. In children, conventional cultivation detected no fungus, while metagenomics detected 14 (82.4%)cases. In adults, the metagenomic screening improved from 14 cases (30.4%) by culture to 32 (69.6%). The fungi were detected mainly Candida (38.1%) and Aspergillus (11.1%). In the basal visit, patients with isolates presented a lower FEV1 and a higher proportion of inhaled steroids use. At 6 months, these isolates were persistent in 47.6% and 11.1% presented new isolates in negative subjects. Patients with acquired fungus isolation presented a worse lung function FEV1 (-120 mL) as compared with persistent negative patients (+109 mL; p =0.088)
Conclusions: Metagenomics studies identifies a larger population of fungal microbiota in CF that remains over time in a good proportion of patients. Newly acquired isolations have an impact on the disease progression.
- Copyright ©ERS 2015
