Mukoviszidose Institute, In den Dauen 6, 53117, Bonn, Germany.
Interdisciplinary Center Clinical Trials (IZKS), University Medical Center Mainz, Langenbeckstraße 1, Mainz, Germany.
Sci Rep. 2020 Nov 4;10(1):18999. doi: 10.1038/s41598-020-75886-w.
Airway inflammation and chronic lung infections in cystic fibrosis (CF) patients are mostly caused by bacteria, e.g. Pseudomonas aeruginosa (PA). The role of fungi in the CF lung is still not well elucidated, but evidence for a harmful and complex role is getting stronger. The most common filamentous fungus in CF is Aspergillus fumigatus (AF). Age and continuous antibiotic treatment have been discussed as risk factors for AF colonisation but did not differentiate between transient and persistent AF colonisation. Also, the impact of co-colonisation of PA and AF on lung function is still under investigation. Data from patients with CF registered in the German Cystic Fibrosis Registry database in 2016 and 2017 were retrospectively analysed, involving descriptive and multivariate analysis to assess risk factors for transient or persistent AF colonisation. Age represented an independent risk factor for persistent AF colonisation. Prevalence was low in children less than ten years, highest in the middle age and getting lower in higher age (≥ 50 years). Continuous antibiotic lung treatment was significantly associated with AF prevalence in all age groups. CF patients with chronic PA infection had a lower lung function (FEV1%predicted), which was not influenced by an additional AF colonisation. AF colonisation without chronic PA infection, however, was significantly associated with a lower function, too. Older age up to 49 years and continuous antibiotic use were found to be the main risk factors for AF permanent colonisation. AF might be associated with decrease of lung function if not disguised by chronic PA infection.
气道炎症和慢性肺部感染是囊性纤维化（CF）患者的主要病因，这些感染大多由细菌引起，例如铜绿假单胞菌（PA）。真菌在 CF 肺部中的作用仍未得到充分阐明，但越来越多的证据表明真菌具有危害性和复杂性。CF 中最常见的丝状真菌是烟曲霉（AF）。年龄和持续抗生素治疗已被讨论为 AF 定植的危险因素，但未能区分 AF 定植的暂时性和持久性。此外，PA 和 AF 的共同定植对肺功能的影响仍在研究中。对 2016 年和 2017 年德国囊性纤维化登记数据库中登记的 CF 患者的数据进行了回顾性分析，涉及描述性和多变量分析，以评估 AF 定植的暂时性或持久性的危险因素。年龄是持续性 AF 定植的独立危险因素。年龄小于 10 岁的儿童患病率较低，中年最高，年龄较大（≥50 岁）时患病率较低。所有年龄段的患者中，持续的抗生素肺部治疗均与 AF 的患病率显著相关。患有慢性 PA 感染的 CF 患者的肺功能（FEV1%预计值）较低，但不会因额外的 AF 定植而受到影响。然而，无慢性 PA 感染的 AF 定植也与较低的肺功能显著相关。年龄在 49 岁以下和持续使用抗生素被认为是 AF 永久定植的主要危险因素。如果 AF 定植不被慢性 PA 感染所掩盖，它可能与肺功能下降有关。
