Airway Colonization by Acrophialophora fusispora in Patients with Cystic Fibrosis

Acrophialophora fusispora is a thermotolerant soil fungus which is very unusual in clinical samples. Here we report four cases of transient or chronic airway colonization by A. fusispora in patients with cystic fibrosis (CF). However, the prevalence of this fungus in CF patients may be underestimated due to the currently poor knowledge of this fungus in most of the medical mycology laboratories. In addition, its clinical importance regarding CF remains to be evaluated

Occurrence and relevance of filamentous fungi in respiratory secretions of patients with cystic fibrosis — a review

International audienceThe colonization of airways by filamentous fungi and the development of respiratory infections require some predisposing factors as encountered in patients with cystic fibrosis (CF). Indeed, the defective mucociliary clearance which characterizes the disease is associated with local immunological disorders. In addition, the prolonged therapy with antibiotics and the use of corticosteroid treatments also facilitate fungal growth. An important fungal biota has been described in respiratory secretions of patients suffering from CF. Aspergillus fumigatus, Scedosporium apiospermum and Aspergillus terreus for filamentous fungi and Candida albicans for yeasts are the main fungal species associated with CF. Although less common, several fungal species including Aspergillus flavus and Aspergillus nidulans may be isolated transiently from CF respiratory secretions, while others such as Exophiala dermatitidis and Scedosporium prolificans may chronically colonize the airways. Moreover, some of them like Penicillium emersonii and Acrophialophora fusispora are encountered in humans almost exclusively in the context of CF. As fungal complications in CF patients are essentially caused by filamentous fungi the present review will not include works related to yeasts. In CF patients, fungi may sometimes be responsible for deterioration of lung function, as occurs in allergic broncho-pulmonary aspergillosis (ABPA) which is the most common fungal disease in this context. Additionally, although the clinical relevance of the fungal airway colonization is still a matter of debate, filamentous fungi may contribute to the local inflammatory response, and therefore to the progressive deterioration of the lung function

Epidemic spread of Pandoraea pulmonicola in a cystic fibrosis center.

International audiencePandoraea spp. are recently discovered bacteria, mainly recovered from cystic fibrosis (CF) patients, but their epidemiology and clinical significance are not well known. We describe an epidemic spread of Pandoraea pulmonicola from 2009 in our CF center, involving 6 out of 243 CF patients. Bacterial identification used amplified ribosomal DNA restriction analysis (ARDRA), MALDI-TOF mass spectrometry (MALDI-TOF MS) and 16S rDNA gene sequencing. The clonal link between strains was assessed with pulsed field gel electrophoresis (PFGE) using XbaI. Clinical data were gathered for all patients. The index case was chronically colonized since 2000. The main hypothesis for this bacterial spread was a droplet cross-transmission, due to preventive measures not being strictly followed. Antibiotic susceptibility testing revealed resistance to beta-lactams, ciprofloxacin and colistin. However, there was susceptibility to trimethoprim-sulfamethoxazole. All patients were chronically colonized with Pseudomonas aeruginosa, and the acquisition of P. pulmonicola resulted in chronic colonization in all patients. Three patients died, and two patients remained clinically stable, whereas one patient had a decline in lung function. This study, which is the first to describe an epidemic spread of P. pulmonicola, notes the potential transmissibility of this bacterial species and the need for infection control measures

Geosmithia argillacea: an Emerging Pathogen in Patients with Cystic Fibrosis▿

We report eight cases of airway colonization by Geosmithia argillacea in patients with cystic fibrosis. This filamentous fungus, resembling members of the genera Penicillium and Paecilomyces, was identified by molecular analysis. All patients carried a mutation on each CFTR (cystic fibrosis transmembrane conductance regulator) allele, with at least one copy of the F508del mutation. The first isolation of this fungus occurred from F508del-homozygous patients at a younger age than in F508del-heterozygous patients. Before recovery of G. argillacea, all patients were treated with itraconazole; two of them had also received voriconazole for an Aspergillus fumigatus infection. However, antifungal susceptibility patterns showed high MICs of voriconazole for all isolates, and high MICs of amphotericin B and itraconazole for the majority of them, but mostly low minimum effective concentrations (MECs) of caspofungin. The appearance and persistence of G. argillacea in the airways were not associated with exacerbation of the disease. However, the clinical implications of G. argillacea, particularly in immunocompromised patients, remain a concern, particularly given recent observations suggesting that this fungus may also cause disseminated infections

Lack of standardization in the procedures for mycological examination of sputum samples from CF patients: a possible cause for variations in the prevalence of filamentous fungi

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MUSIC-HALL PARADE N °24

Comprend : UNE PETITE FILLE / J. DATIN et Claude NOUGARO ; Claude NOUGARO, avec Michel LEGRAND et son ensemble - LES COMEDIENS / Charles AZNAVOUR et Jacques PLANTE ; Jacqueline FRANCOIS avec Jean-Michel DEFAYE et son orchestre - SHEILA / T. ROE et Claude CARRERE ; Lucky BLONDO et les LuckySTARS - CROIS-MOI CA DURERA / G. BECAUD et P. DELANOE ; Nana MOUSKOURI, avec Raymond BERNARD et son orchestre - LE TANGO DES EMPLOYES DE BUREAU / Guy MAGENTA et H. KUBNICK ; les 3 Ménestrels avec Armand MIGIANI et son orchestre - SI UN JOUR / R. COGOI ; Robert COGOI et orchestre dir. Jack SAY - L'IDOLE DES JEUNES / Jack LEWIS et Ralph BERNET ; Johnny HALLYDAY - VA-T'EN LOIN / Gilbert BECAUD et M. VIDALIN ; Isabelle AUBRET, avec Jean-Michel DEFAYE et son orchestre - AH, SI J'ETAIS RESTE CELIBATAIRE / BOERMANS et Guy de PARIS ; Emile SULLON et son Orchestre - ADIEU MON PAYS / A. HRUGUEN et E. MACIAS ; Maya CASABIANCA, avec Jean CLAUDRIC et son orchestre - MAGALI / G. VERLOR et R. NYEL ; Robert NYEL, avec Jean-Michel DEFAYE et son orchestre - CUANDO CALIENTA EL SOL ("Quand le soleil était là") / Carlos RIGUAL - Mario RIGUAL et Fernand BONIFAY ; les ALCARSON, avec Jean CLAUDRIC et son orchestreBnF-Partenariats, Collection sonore - BelieveContient une table des matière