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[Mycological surveillance of children with cystic fibrosis]
R Blaschke-Hellmessen1, H Spitzer, K D Paul
1Institut für Medizinische Mikrobiologie, Medizinischen Akademie Carl Gustav Carus, Dresden.
Insights
This study monitored fungal infections in cystic fibrosis (CF) patients, finding that more severe CF and longer chemotherapy correlate with increased fungal presence. Regular mycological surveillance is recommended for CF patients based on disease severity.
Area of Science:
- Medical Mycology
- Pediatric Pulmonology
- Infectious Diseases
Background:
- Cystic fibrosis (CF) patients exhibit increased susceptibility to fungal infections.
- Fungal colonization and infection can complicate CF management and disease progression.
Purpose of the Study:
- To evaluate the incidence of fungal colonization in CF patients.
- To correlate mycological findings with CF clinical course and chemotherapy.
- To assess the need for mycological surveillance in CF patients.
Main Methods:
- Mycological surveillance of oral cavity, respiratory secretions, sputum, feces, and urine.
- Measurement of serum antibodies against Candida albicans and Aspergillus fumigatus.
- Comparison of CF patients with healthy control groups.
Main Results:
- A parallel increase in fungal findings was observed with CF disease progression and chemotherapy duration.
- Moderate CF cases showed mycological results similar to healthy controls.
- No cases of systemic candidiasis or aspergillosis were reported.
Conclusions:
- CF patients are predisposed to fungal infections, particularly Aspergillus fumigatus.
- Recommend mycological surveillance tailored to CF clinical severity: annually for mild cases, quarterly for severe cases.
Abstract:
The mycological surveillance included 121 patients aged 1 to 21 years treated from 1981 to 1987 in the Centre of Cystic Fibrosis in Dresden. The control groups comprised 136 resp. 140 healthy children aged 1 to 16 years. The study evaluated the incidence of fungi in the oral cavity, bronchial secreta, sputum, faeces and urine as well as the specific serum antibodies to Candida albicans and Aspergillus fumigatus in correlation to the course of the cystic fibrosis and the applied chemotherapy. The study pointed out a parallel run concerning the progression of the clinical manifestation of the basic disease, the duration of the required chemotherapy and the mycological findings indicating more and more pathological levels. The mycological results of the children with a moderate course of cystic fibrosis were conformable to the findings of the children of the control groups. Systemic candidosis or aspergillosis were not seen. Because patients suffering from cystic fibrosis are predisposed for infections with fungi, especially with Aspergillus fumigatus, the authors recommend a mycological surveillance of these patients depending on the clinical course of cystic fibrosis: once in twelve months for patients with mild symptoms and every third month for patients with severe symptoms.