Type

Journal Article

Authors

Noel G McElvaney
Shane J O'Neill
Cedric Gunaratnam
Kathleen Bennett
Elaine O'Donoghue
Sanjay H Chotirmall

Subjects

Microbiology

Topics
female disease progression sputum drug therapy candidiasis epidemiology growth development male incidence candida albicans isolation purification young adult physiology prospective studies follow up studies physiopathology body mass index complications microbiology prognosis anti bacterial agents therapeutic use colony count microbial humans adult cystic fibrosis recurrence forced expiratory volume

Sputum Candida albicans presages FEV₁ decline and hospital-treated exacerbations in cystic fibrosis. (2010)

Abstract The role of Candida albicans in the cystic fibrosis (CF) airway is underexplored. Considered a colonizer, few question its pathogenic potential despite high isolation frequencies from sputum culture. We evaluated the frequency and identified the strongest predictors of C albicans colonization in CF. Independent associations of colonization with clinical outcomes were determined, and the longitudinal effects of C albicans acquisition on BMI and FEV₁ were evaluated. A prospective observational study of 89 patients with CF was performed (3,916 sputum samples over 11 years). Frequency of C albicans growth in sputum allowed classification of the cohort into colonizers and noncolonizers. BMI, FEV₁, hospital-treated exacerbations, and other clinical parameters were followed throughout the study to determine association with colonization status. Multivariate regression determined the strongest predictors of colonization and for clinical effects after adjustment for confounders. Repeated-measures analysis of variance assessed the longitudinal effect of colonization on BMI and FEV₁. Colonization with C albicans was frequent (49.4%) and best predicted by pancreatic insufficiency (P = .014), osteopenia (P = .03), and cocolonization with Pseudomonas species (P = .002). C albicans colonization significantly predicted hospital-treated exacerbations (P = .004) after adjustment for confounders. Exacerbation rate significantly increased in patients with chronic or intermittent colonizations following first acquisition of C albicans. Colonization accelerated rates of decline for BMI (P < .0001) and FEV₁ (P < .001). Airway colonization with C albicans presaged a greater rate of FEV₁ decline and hospital-treated exacerbations in CF.
Collections Ireland -> Royal College of Surgeons in Ireland -> PubMed

Full list of authors on original publication

Noel G McElvaney, Shane J O'Neill, Cedric Gunaratnam, Kathleen Bennett, Elaine O'Donoghue, Sanjay H Chotirmall

Experts in our system

1
Noel G McElvaney
Royal College of Surgeons in Ireland
Total Publications: 194
 
2
Shane J O'Neill
Royal College of Surgeons in Ireland
Total Publications: 84
 
3
Cedric Gunaratnam
Royal College of Surgeons in Ireland
Total Publications: 18
 
4
Kathleen Bennett
Royal College of Surgeons in Ireland
Total Publications: 137
 
5
Sanjay H Chotirmall
Royal College of Surgeons in Ireland
Total Publications: 22