Fungal colonization in cystic fibrosis – correlating variables

<b>Purpose:</b> As the life expectancy of patients with cystic fibrosis improves the rate of opportunistic fungal infections has also increased. There are not many studies concerning the clinical implications of these types of infections. The aim of this report was to assess a population of Cystic Fibrosis patients according to fungal colonization status. <b>Methods:</b> 32 patients from an adult cystic fibrosis clinic were included. Genotype, sputum colonization, lung function (FEV1), nutritional status (BMI), liver enzyme levels and fecal elastase were considered. For statistical purposes patients were divided into two groups according to whether they had fungal colonization or not. <b>Results:</b> In total 25 % were colonized by fungi. No difference was found between the two groups regarding genotype (little to no CFTR function or some CFTR function), FEV1 (69±10% vs 74±6%), BMI (23±1 kg/m2) or pancreatic function. There was a positive tendency between fungal colonization and altered liver enzymes (p 0.06), corrected for age, gender, antibiotic intake and microbiology profile. A positive correlation was found between fungal and bacterial colonization, mainly MRSA, Pseudomonas aeruginosa and Burkholderia cepacia, 2.3±0.7 vs 1.5±0.2 (p 0.02). <b>Conclusion:</b> In this study the prevalence of fungal colonization seems to be lower than expected and no correlation with disease severity or CFTR function was found. <b>Clinical Implications:</b> The positive association with bacterial colorization is possibly part of the complex microbial interaction pathway requiring further clinical research. The positive tendency between fungal colonization and cystic fibrosis-liver disease is interesting and may underline a phenotypic correlation.