Author:
Kröner Carolin,Kappler Matthias,Grimmelt Ann-Christin,Laniado Gudrun,Würstl Benjamin,Griese Matthias
Abstract
Abstract
Background
The relevance of Trichosporon species for cystic fibrosis (CF) patients has not yet been extensively investigated.
Methods
The clinical course of CF patients with Trichosporon spp. in their respiratory secretions was analysed between 2003 and 2010 in the Munich CF center. All respiratory samples of 360 CF patients (0 – 52.4 years; mean FEV1 2010 81.4% pred) were investigated.
Results
In 8 patients (2.2%, 3 male, mean age 21.8 years) Trichosporon was detected at least once. One patient carried T. asahii. One patient carried T. mycotoxinivorans and one patient T. inkin as determined by DNA sequencing. As potential risk factors for Trichosporon colonization steroid treatment, allergic bronchopulmonary aspergillosis (ABPA) and CF associated diabetes were identified in 6, 5, and 2 patients respectively. For one patient, the observation period was not long enough to determine the clinical course. One patient had only a single positive specimen and exhibited a stable clinical course determined by change in forced expiratory volume in one second (FEV1), body-mass-index (BMI), C-reactive protein (CRP) and immunoglobulin G (IgG). Of 6 patients with repeatedly positive specimen (mean detection period 4.5 years), 4 patients had a greater decline in FEV1 than expected, 2 of these a decline in BMI and 1 an increase in IgG above the reference range. 2 patients received antimycotic treatment: one patient with a tormenting dry cough subjectively improved under Amphotericin B inhalation; one patient with a severe exacerbation due to T. inkin was treated with i.v. Amphotericin B, oral Voriconazole and Posaconazole which stabilized the clinical condition.
Conclusions
This study demonstrates the potential association of Trichosporon spp. with severe exacerbations in CF patients.
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine
Reference29 articles.
1. Pritchard RC, Muir DB: Trichosporon Beigelii - survey of isolates from clinical material. Pathology. 1985, 17 (1): 20-23. 10.3109/00313028509063717.
2. Walsh TJ, Melcher GP, Lee JW, Pizzo PA: Infections due to Trichosporon species: new concepts in mycology, pathogenesis, diagnosis and treatment. Curr Top Med Mycol. 1993, 5: 79-113.
3. Molnar O, Schatzmayr G, Fuchs E, Prillinger H: Trichosporon mycotoxinivorans sp. nov., a new yeast species useful in biological detoxification of various mycotoxins. Syst Appl Microbiol. 2004, 27 (6): 661-671. 10.1078/0723202042369947.
4. Miceli MH, Diaz JA, Lee SA: Emerging opportunistic yeast infections. Lancet Infect Dis. 2011, 11 (2): 142-151. 10.1016/S1473-3099(10)70218-8.
5. Fleming RV, Walsh TJ, Anaissie EJ: Emerging and less common fungal pathogens. Infect Dis Clin North Am. 2002, 16 (4): 915-933. 10.1016/S0891-5520(02)00041-7. vi-vii
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