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

Hdl Handle:
http://hdl.handle.net/10147/126509
Title:
Sputum Candida albicans presages FEV₁ decline and hospital-treated exacerbations in cystic fibrosis.
Authors:
Chotirmall, Sanjay H; O'Donoghue, Elaine; Bennett, Kathleen; Gunaratnam, Cedric; O'Neill, Shane J; McElvaney, Noel G
Affiliation:
Department of Respiratory Medicine, Beaumont Hospital, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. schotirmall@rcsi.ie
Citation:
Sputum Candida albicans presages FEV₁ decline and hospital-treated exacerbations in cystic fibrosis. 2010, 138 (5):1186-95 Chest
Journal:
Chest
Issue Date:
Nov-2010
URI:
http://hdl.handle.net/10147/126509
DOI:
10.1378/chest.09-2996
PubMed ID:
20472859
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.
Item Type:
Article
Language:
en
MeSH:
Adult; Anti-Bacterial Agents; Body Mass Index; Candida albicans; Candidiasis; Colony Count, Microbial; Cystic Fibrosis; Disease Progression; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Incidence; Male; Prognosis; Prospective Studies; Recurrence; Sputum; Young Adult
ISSN:
1931-3543

Full metadata record

DC FieldValue Language
dc.contributor.authorChotirmall, Sanjay Hen
dc.contributor.authorO'Donoghue, Elaineen
dc.contributor.authorBennett, Kathleenen
dc.contributor.authorGunaratnam, Cedricen
dc.contributor.authorO'Neill, Shane Jen
dc.contributor.authorMcElvaney, Noel Gen
dc.date.accessioned2011-03-31T09:42:27Z-
dc.date.available2011-03-31T09:42:27Z-
dc.date.issued2010-11-
dc.identifier.citationSputum Candida albicans presages FEV₁ decline and hospital-treated exacerbations in cystic fibrosis. 2010, 138 (5):1186-95 Chesten
dc.identifier.issn1931-3543-
dc.identifier.pmid20472859-
dc.identifier.doi10.1378/chest.09-2996-
dc.identifier.urihttp://hdl.handle.net/10147/126509-
dc.description.abstractThe 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.-
dc.description.abstractA 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.-
dc.description.abstractColonization 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).-
dc.description.abstractAirway colonization with C albicans presaged a greater rate of FEV₁ decline and hospital-treated exacerbations in CF.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAnti-Bacterial Agents-
dc.subject.meshBody Mass Index-
dc.subject.meshCandida albicans-
dc.subject.meshCandidiasis-
dc.subject.meshColony Count, Microbial-
dc.subject.meshCystic Fibrosis-
dc.subject.meshDisease Progression-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshForced Expiratory Volume-
dc.subject.meshHumans-
dc.subject.meshIncidence-
dc.subject.meshMale-
dc.subject.meshPrognosis-
dc.subject.meshProspective Studies-
dc.subject.meshRecurrence-
dc.subject.meshSputum-
dc.subject.meshYoung Adult-
dc.titleSputum Candida albicans presages FEV₁ decline and hospital-treated exacerbations in cystic fibrosis.en
dc.typeArticleen
dc.contributor.departmentDepartment of Respiratory Medicine, Beaumont Hospital, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. schotirmall@rcsi.ieen
dc.identifier.journalChesten
dc.description.provinceLeinster-

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