Abstract
Aspergillus fumigatus (Af) frequently colonizes the respiratory tract of patients with cystic fibrosis (CF). Af is associated with loss of pulmonary function and allergic bronchopulmonary aspergillosis (ABPA), a hypersensitivity fungal lung disease. Environmental factors have impact on CF patients’ lung function variation. The aim of this nationwide questionnaire survey was to investigate the amount of CF patients with frequent pet contact including pet species and to examine the potential impact of frequent pet contact on the occurrence of Af colonization and ABPA diagnosis in these patients. The survey was carried out in 31 German CF centers in 2018. A total of 1232 who completed the surveys were included, and statistical analysis was performed by chi-squared test. Within the study cohort 49.8% of subjects (n = 614; CF patients < 18years: 49.4%, n = 234; ≥ 18years: 50.1%, n = 380) reported frequent contact to pets, of which 60.7% reported frequent contact to dogs, 42.3% to cats and other animals. Of those with frequent pet contact, 71.8% (n = 441) had contact to one pet or more pets from the same family. Af colonization was not significantly associated with frequent pet contact. ABPA diagnosis was documented in 16.7% (n = 206) of all included CF patients and was significantly associated with frequent pet contact (18.9%, n = 116, p = 0.042), confirming previous single center examinations. Particularly, patients with frequent contact to dogs showed an increased ABPA prevalence of 21.3%. Frequent pet contact might be a risk factor for ABPA. CF patients who are sensitized to Af should be informed about the increased risk to develop an ABPA by frequent pet contact. Patients with recurrent onset of ABPA should be evaluated in terms of frequent pet contact.
Highlights
Cystic fibrosis (CF) is a life-limiting recessive genetic disease
Inhaling Aspergillus fumigatus (Af) spores into the lungs may cause multiples diseases including invasive pulmonary aspergillosis, aspergilloma (Mousavi et al, 2016) and growth of Af hyphae within the bronchial lumen triggers an immunoglobulin E (IgE)-mediated hypersensitivity response that results in airway inflammation, bronchospasm, and bronchiectasis (Armstead et al, 2014; Janahi et al, 2017)
The allergic bronchopulmonary aspergillosis (ABPA) diagnosis was determined in every single cystic fibrosis (CF) center and was based on the minimal 2003 Cystic Fibrosis Foundation (CFF) consensus criteria (Stevens et al, 2003)
Summary
Cystic fibrosis (CF) is a life-limiting recessive genetic disease. Mucus retention, chronic infections and inflammation in the airways lead to progressive respiratory impairment (Elborn, 2016). The respiratory tract of 10.3 to 60 % of CF patients is colonized by Af (Pihet et al, 2009; Ziesing et al, 2016; Warris et al, 2019; Hong et al, 2020) The presence of this environmental filamentous fungus in CF sputum is associated with worse respiratory quality of life (Hong et al, 2020). Dogs, and other pets results in several million pet-related infections each year These parasitic, fungal, bacterial, viral or arthropod dependent infections range from selflimiting skin conditions to life-threatening systemic illnesses (Rabinowitz et al, 2007). This questionnaire survey was conducted to determine frequent pet contact and pet species in CF, to examine the relationship between frequent pet contact and Af colonization as well as ABPA diagnosis in children and adult patients with CF
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