Noni Maria, Katelari Anna, Kapi Aikaterini, Stathi Angeliki, Dimopoulos George, Doudounakis Stavros-Eleftherios
Medical School, Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Cystic Fibrosis, "Aghia Sophia" Children's Hospital, Athens, Greece.
Mycoses. 2017 Sep;60(9):594-599. doi: 10.1111/myc.12634. Epub 2017 May 15.
Species of the Scedosporium apiospermum complex are the second most frequent filamentous fungi after Aspergillus fumigatus that can be found in cystic fibrosis (CF). Mixed colonisation by S. apiospermum complex and A. fumigatus is also quite common. In this study we summarise all CF patients who were colonised by S. apiospermum complex during their childhood and we present two CF patients who were treated as fungal bronchitis due to S. apiospermum complex. The medical records of 400 CF patients were reviewed in order to identify those with positive respiratory cultures for S. apiospermum complex. Scedosporium apiospermum complex was isolated in 10 CF patients and six of them had more than two positive sputum cultures during the study period. By the time of first isolation, the median age was 14.5 years, the median BMI was 19.41 kg/m , the median predicted FEV % was 78.65% and six patients had a history of A. fumigatus isolation. Two patients presented symptoms of infection while they were colonised by S. apiospermum complex. A rapid remission of their symptoms was observed only when antifungal therapy was administered. Antifungal treatment should be considered in CF patients who present symptoms of infection not responding to antibacterial therapy and S. apiospermum complex is persistently growing in sputum cultures.
在囊性纤维化（CF）患者中，阿萨希丝孢霉复合体（Scedosporium apiospermum complex）是继烟曲霉（Aspergillus fumigatus）之后第二常见的丝状真菌。阿萨希丝孢霉复合体与烟曲霉的混合定植也相当常见。在本研究中，我们总结了所有在儿童期被阿萨希丝孢霉复合体定植的CF患者，并介绍了两名因阿萨希丝孢霉复合体导致真菌性支气管炎而接受治疗的CF患者。我们回顾了400例CF患者的病历，以确定那些呼吸道培养物中阿萨希丝孢霉复合体呈阳性的患者。在10例CF患者中分离出了阿萨希丝孢霉复合体，其中6例在研究期间有两次以上的痰培养阳性。首次分离时，中位年龄为14.5岁，中位体重指数为19.41kg/m²，中位预测第一秒用力呼气容积（FEV₁）百分比为78.65%，6例患者有烟曲霉分离史。两名患者在被阿萨希丝孢霉复合体定植时出现感染症状。仅在给予抗真菌治疗后，观察到他们的症状迅速缓解。对于出现对抗菌治疗无反应的感染症状且痰培养中阿萨希丝孢霉复合体持续生长的CF患者，应考虑进行抗真菌治疗。
