WS19.5 Characterization of fungal colonization phenotypes in pediatric cystic fibrosis lung disease

Abstract

Objectives: Fungi, particularly Aspergillus and Candida species, are increasingly found in cystic fibrosis (CF) airway fluids. However, their relationship to other CF pathogens, medications and lung function, especially in CF children, remains poorly understood. To address this question, we analyzed the associations of fungal colonization with microbiological and clinical parameters of pediatric CF patients. Methods: Fungal colonization was categorized in n = 128 CF patients based on Chotirmall et al. (Chest 2010). Candida albicans (CA) was the most prevalent fungus detected in CF airway fluids, followed by C. non-albicans > Aspergillus fumigatus (AF) > A. non-fumigatus species. Colonization with CA correlated positively with age, inhaled antibiotic use, and Aspergillus species, while an inverse correlation with Haemophilus and no association with S. aureus or Pseudomonas was found. Colonization with AF correlated positively with age, inhaled antibiotics, Pseudomonas, Stenotrophomonas, atypical mycobacteria and CF-related diabetes and inversely with Haemophilus. ABPA showed no correlation with AF colonization, but with non-fumigatus species and use of azithromycin. Colonization with AF or CA correlated inversely with cross-sectional FEV1, but not with MEF25. Colonization with AF correlated with longitudinal FEV1 decline. Conclusion: This study suggests that colonization with CA or AF is affected by bacterial co-colonization and may modulate lung function already in pediatric CF.