Tuberkuloz ve toraks · 2025
Fungal colonization and its clinical associations in pediatric cystic fibrosis: A 12-year single-center cohort study.
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Ocak Ece, Kartal Öztürk Gökçen, Halis Ece, Girgin Dindar Bahar, Çoksüer Fevziye, Özaslan Mehmet Mustafa, Barlik Meral, Öğütçü Atacan, Gülen Figen
Аннотация
INTRODUCTION: Fungal organisms are increasingly isolated from respiratory samples of patients with cystic fibrosis (CF), yet their clinical relevance remains incompletely understood. This study aimed to assess the frequency of colonization and clinical characteristics of CF patients with fungal colonization.
MATERIALS AND METHODS: We retrospectively reviewed CF patients followed at the Pediatric Pulmonology Division of Ege University between January 2011 and December 2022. Those with at least one respiratory culture analyzed for fungi were included. Fungal colonization was defined as the growth of the same species in at least 50% of cultures within one year. Demographic, clinical, spirometric, and microbiological data were evaluated.
RESULT: Among the 98 patients, median age was 9.6 years (1.7-32.1), and 54.1% were male. Fungal growth was detected in 51 patients (52.0%), and 37 (37.7%) met the criteria for colonization. Candida albicans (32.7%) and Aspergillus fumigatus (13.3%) were the most commonly isolated species. Patients with fungal colonization were older (p< 0.001), more likely to have chronic Pseudomonas aeruginosa colonization (p< 0.001), had more inhaled antibiotic use (p< 0.001), CF-related liver disease (p= 0.018), and had lower FEV1% (p= 0.005) and body mass index z-scores (zBMI) (p< 0.001). Regression analyses identified lower zBMI (95% CI: 0.527-0.948; p= 0.021) and P. aeruginosa colonization (95% CI: 1.237-8.809; p= 0.017) as independent predictors of fungal colonization.
CONCLUSIONS: Fungal colonization is common in children with CF and is associated with older age, impaired lung function, lower zBMI, and P. aeruginosa co-colonization. These findings support the need for routine fungal surveillance and further prospective studies to clarify clinical implications. Further research is needed to determine whether these relationships are causal.
MATERIALS AND METHODS: We retrospectively reviewed CF patients followed at the Pediatric Pulmonology Division of Ege University between January 2011 and December 2022. Those with at least one respiratory culture analyzed for fungi were included. Fungal colonization was defined as the growth of the same species in at least 50% of cultures within one year. Demographic, clinical, spirometric, and microbiological data were evaluated.
RESULT: Among the 98 patients, median age was 9.6 years (1.7-32.1), and 54.1% were male. Fungal growth was detected in 51 patients (52.0%), and 37 (37.7%) met the criteria for colonization. Candida albicans (32.7%) and Aspergillus fumigatus (13.3%) were the most commonly isolated species. Patients with fungal colonization were older (p< 0.001), more likely to have chronic Pseudomonas aeruginosa colonization (p< 0.001), had more inhaled antibiotic use (p< 0.001), CF-related liver disease (p= 0.018), and had lower FEV1% (p= 0.005) and body mass index z-scores (zBMI) (p< 0.001). Regression analyses identified lower zBMI (95% CI: 0.527-0.948; p= 0.021) and P. aeruginosa colonization (95% CI: 1.237-8.809; p= 0.017) as independent predictors of fungal colonization.
CONCLUSIONS: Fungal colonization is common in children with CF and is associated with older age, impaired lung function, lower zBMI, and P. aeruginosa co-colonization. These findings support the need for routine fungal surveillance and further prospective studies to clarify clinical implications. Further research is needed to determine whether these relationships are causal.