Persistence ofcandida dubliniensisin the lower airways of cystic fibrosis patients

Abstract

Background: Candida dubliniesis is emerging yeast in the respiratory tract of patients with cystic fibrosis (CF). Aims and objectives: To determine the frequency of C . dubliniensis recovered from lower respiratory samples of CF patients and compare between pediatric (≤ 18 year old) and adult (> 18 year old) CF patients. Methods: A prospective study of 52 CF patients (38 pediatric and 14 adult CF patients) over a period of 14 months.Respiratory secretions were cultured for Candida species and identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Results: Candida isolates were obtained from 76.9% (40/52) patients. There were 56.2% (77/137) of respiratory specimens positive for C andida species. C dubliniensis was the most prevalent Candida sp. 65%(50/77) isolated from 29 CF patients more often from adults than children (91.3% vs 53.7%; respectively). Other Candida spp. isolated was C. albicans (27.2%), C. tropicalis (6.5%) and C. glabrata (1.3%). In CF patients, two or more Candida spp. were never isolated from the same respiratory specimen. During the study period, C. dubliniensis was isolated repeatedly in 11 (27.5%) CF patients and transient isolates were found in 13 (32.5%) patients. C. dubliniensis was recovered from the first respiratory specimen followed by other Candida spp. in subsequent samples in 5 (12.5%) patients. The prevalence of C . dubliniensis was higher in adults harboring Pseudomonas aeruginosa , while in pediatric patients C. dubliniensis coexisted with Staphylococcus aureus. Conclusion: High and frequent occurrence of C. dubliniensis as the persistent species isolated from the lower respiratory secretions of CF patients.