Persistence ofCandidaspecies in the respiratory tract of cystic fibrosis patients

Abstract

It is still controversial as to whether Candida spp. are transient or persistent colonizers of the respiratory tract of cystic fibrosis (CF) patients. We conducted a prospective study of 56 CF patients over a 30 month period to assess the distribution and persistence of different Candida spp. In vitro antifungal susceptibility testing was performed and the C. albicans isolates were typed with CARE-2 hybridization and other Candida spp. by RAPD-PCR for persistence and transmission. We found that the mean persistence of the most frequent Candida spp. was >or= 9 months. In patients from whom more than 10 isolates were recovered, we noted that at least 30% were genetically related and transmission of C. albicans in siblings was observed. The majority of all isolates were susceptible to all antifungals tested. We concluded that there was long-term persistence of Candida in the respiratory tract of CF patients and that transmission between siblings may be one possible means of acquisition. Whether long-term colonization with Candida strains can contribute to the chronic infection and inflammation in the CF lung requires further investigation.

The Airway Microbiota in Cystic Fibrosis: A Complex Fungal and Bacterial Community—Implications for Therapeutic Management

“…Among them, filamentous fungi belonging to the genera Aspergillus (in particular Aspergillus fumigatus ), and Penicillium have already been described as pathogens in CF patients [2]–[5], [35], [45]. Candida albicans and species from the Candida parapsilosis complex have been recently recognized as medically important organisms colonizing CF patients [2], [4], [40], [42], [43]. Although their clinical relevance is still matter of debate, long-term persistence of Candida strains have been described in CF respiratory tracts [4], [40], [42], [43], [49].…”

“…Candida albicans and species from the Candida parapsilosis complex have been recently recognized as medically important organisms colonizing CF patients [2], [4], [40], [42], [43]. Although their clinical relevance is still matter of debate, long-term persistence of Candida strains have been described in CF respiratory tracts [4], [40], [42], [43], [49]. Clavispora is a yeast genus that includes Clavispora lusitaniae (teleomorph of Candida lusitaniae ); this ascomycete has already been isolated from sputa [36], [40].…”

Long-Term Rasamsonia argillacea Complex Species Colonization Revealed by PCR Amplification of Repetitive DNA Sequences in Cystic Fibrosis Patients

“…Patient-to-patient transmission between siblings with CF or acquisition of the same strain from an identical environmental source within the family situation has been demonstrated for many bacterial pathogens, including methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Achromobacter xylosoxidans (35,36,37,38). Likewise, concordance in the genotypes colonizing the respiratory tract of siblings suffering from CF has also been reported for some fungal pathogens, like Candida species (39) and Pneumocystis jirovecii (40). Investigations should be conducted in order to clarify the ecology of these fungi and to identify potential niches in the indoor environment of the patients.…”

Molecular epidemiology of Candida albicans and Candida glabrata strains isolated from intensive care unit patients in Poland

“…Knowing the source of infection and detection of possible routes of transmission can help with the prevention of clonal spread of pathogenic fungi. RAPD is one of the most frequently used genotyping methods for epidemiological investigations of Candida infections worldwide (Lian et al 2004, Marol & Yücesoy 2008, Muthig et al 2010, Karaman et al 2013). This technique is easy to perform as well as rapid, cost-effective and suitable for the typing of a large number of strains (Noumi et al 2009).…”