Association of chronic Candida albicans respiratory infection with a more severe lung disease in patients with cystic fibrosis

Pediatr Pulmonol. 2015 Nov;50(11):1082-9. doi: 10.1002/ppul.23302. Epub 2015 Sep 18.

Abstract

Background: Despite the increase in fungal isolates, the significance of chronic Candida albicans airway colonization in CF is unclear.

Aim: To investigate the impact of C. albicans airway colonization on CF disease severity.

Methods: Longitudinal analysis of clinical data from CF patients followed during 2003-2009 at our CF center. Patients were stratified based on their C. albicans colonization status--chronic, intermittent, and none.

Results: A total of 4,244 cultures were obtained from 91 patients (mean age 19.7 years, range 5-68). The three colonization groups were similar in age, gender,and body mass index (BMI). Compared to the non-colonized group (n = 27, 30%), the chronic C. albicans colonization group (n = 34, 37%), had a significantly lower FEV1 percent predicted (74.3 ± 23.1% vs. 93.9% ± 22.2) with a higher annual rate of FEV1 decline (-1.9 ± 4.2% vs. 0.7 ± 4.5%). The patients who were intermittently colonized with C. albicans had intermediate values.

Conclusions: Chronic respiratory colonization of C. albicans is associated with worsening of FEV1 in CF. Prospective studies are needed to confirm this finding and to corroborate whether indeed C. albicans drives a deleterious lung phenotype.

Keywords: Cystic fibrosis; disease progression; forced expiratory volume/physiology; sputum/microbiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Mass Index
  • Candida albicans / isolation & purification*
  • Candidiasis / complications*
  • Candidiasis / microbiology
  • Candidiasis / physiopathology
  • Child
  • Child, Preschool
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / microbiology
  • Cystic Fibrosis / physiopathology
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Lung / microbiology
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Respiratory Tract Infections / complications*
  • Respiratory Tract Infections / microbiology
  • Respiratory Tract Infections / physiopathology
  • Severity of Illness Index
  • Young Adult