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Risk factors for persistent Aspergillus respiratory isolation in cystic fibrosis.
Open accessAbstract
Background Aspergillus species are increasingly detected in the respiratory tracts of individuals with cystic fibrosis (CF), and chronic Aspergillus fumigatus is associated with more frequent hospitalizations for pulmonary exacerbations. However, patient and clinical factors that may contribute to the acquisition of persistent Aspergillus infection have yet to be identified. The objective of this study was to identify risk factors for development of Aspergillus respiratory isolation in CF.Methods A retrospective cohort study of participants in the CF Foundation Patient Registry between 2006 and 2012 was conducted. Generalized estimating equation models were used to evaluate the association between the development of persistent Aspergillus respiratory isolation and individual level demographic and clinical characteristics.Results Among 16,095 individuals with CF followed from 2006 to 2012, 1541 (9.6%) subjects developed persistent Aspergillus isolation. White race (Odds Ratio [OR] 1.74, 95% confidence interval 1.23, 2.48, p<0.001) and pancreatic insufficiency (OR 1.50, 95% CI 1.09, 2.06, p<0.001) were found to be risk factors for persistent Aspergillus isolation. Chronic therapies, including inhaled antibiotics (OR 1.33; 95% CI 1.21, 1.46), macrolides (OR 1.23, 95% CI 1.14, 1.32, p<0.001), and inhaled corticosteroids (OR 1.13, 95% CI 1.04, 1.20, p<0.001) were also independently associated with an increased risk for persistent Aspergillus isolation.Conclusions We identified macrolides and inhaled antibiotics, which individually have been shown to improve CF outcomes, and inhaled corticosteroids as risk factors for developing persistent Aspergillus isolation. Further work is needed to determine whether these associations are causal or due to confounding by other factors.
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“This can be seen in the finding that white CF patients have higher risk for persistent Aspergillus spp. colonization (OR 1.74, 95% CI 1.23 to 2.48, p = 0.002) than black or African American CF patients [83].”
From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [83]
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Race and ethnicity: Risk factors for fungal infections?
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Metadata
- Authors
- Hong, G., Psoter, K. J., Jennings, M. T., Merlo, C. A., Boyle, M. P., Hadjiliadis, D., Kawut, S. M., & Lechtzin, N.
- Affiliations
- University of Pennsylvania Health System (US)
- Johns Hopkins University (US)
- University of Pennsylvania (US)
- Corresponding author
- Hong, Gina
- ORCID
- Venue
- Journal of Cystic Fibrosis
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 17
- Issue
- 5
- Pages
- 624-630
- ISSN
- 1569-1993 (ISSN-L)
- PMC
- PMC6681666
- OpenAlex
- W2787382087
- Cited by
- 59
- References
- 45
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 13 · 2020: 7 · 2019: 8 · 2018: 4
- FWCI
- 6.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Cystic Fibrosis (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Cystic Fibrosis Foundation (HONG14A0)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
- Keywords
- Aspergillus fumigatus, respiratory isolation, risk factors, macrolides, inhaled antibiotics, inhaled corticosteroids, pancreatic insufficiency, race, pulmonary exacerbations
- MeSH terms
- Administration, Inhalation, Adolescent, Adrenal Cortex Hormones, Adult, Anti-Bacterial Agents, Aspergillosis, Aspergillus fumigatus, Child, Cystic Fibrosis, Female, Humans, Male, Retrospective Studies, Risk Factors, Macrolides
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