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September 22, 2019  |  

Developing collaborative works for faster progress on fungal respiratory infections in cystic fibrosis.

Authors: Schwarz, Carsten and Vandeputte, Patrick and Rougeron, Amandine and Giraud, Sandrine and Dugé de Bernonville, Thomas and Duvaux, Ludovic and Gastebois, Amandine and Alastruey-Izquierdo, Ana and Martín-Gomez, Maria Teresa and Mazuelos, Estrella Martin and Sole, Amparo and Cano, Josep and Pemán, Javier and Quindos, Guillermo and Botterel, Françoise and Bougnoux, Marie-Elisabeth and Chen, Sharon and Delhaès, Laurence and Favennec, Loïc and Ranque, Stéphane and Sedlacek, Ludwig and Steinmann, Joerg and Vazquez, Jose and Williams, Craig and Meyer, Wieland and Le Gal, Solène and Nevez, Gilles and Fleury, Maxime and Papon, Nicolas and Symoens, Françoise and Bouchara, Jean-Philippe

Cystic fibrosis (CF) is the major genetic inherited disease in Caucasian populations. The respiratory tract of CF patients displays a sticky viscous mucus, which allows for the entrapment of airborne bacteria and fungal spores and provides a suitable environment for growth of microorganisms, including numerous yeast and filamentous fungal species. As a consequence, respiratory infections are the major cause of morbidity and mortality in this clinical context. Although bacteria remain the most common agents of these infections, fungal respiratory infections have emerged as an important cause of disease. Therefore, the International Society for Human and Animal Mycology (ISHAM) has launched a working group on Fungal respiratory infections in Cystic Fibrosis (Fri-CF) in October 2006, which was subsequently approved by the European Confederation of Medical Mycology (ECMM). Meetings of this working group, comprising both clinicians and mycologists involved in the follow-up of CF patients, as well as basic scientists interested in the fungal species involved, provided the opportunity to initiate collaborative works aimed to improve our knowledge on these infections to assist clinicians in patient management. The current review highlights the outcomes of some of these collaborative works in clinical surveillance, pathogenesis and treatment, giving special emphasis to standardization of culture procedures, improvement of species identification methods including the development of nonculture-based diagnostic methods, microbiome studies and identification of new biological markers, and the description of genotyping studies aiming to differentiate transient carriage and chronic colonization of the airways. The review also reports on the breakthrough in sequencing the genomes of the main Scedosporium species as basis for a better understanding of the pathogenic mechanisms of these fungi, and discusses treatment options of infections caused by multidrug resistant microorganisms, such as Scedosporium and Lomentospora species and members of the Rasamsonia argillacea species complex.

Journal: Medical mycology
DOI: 10.1093/mmy/myx106
Year: 2018

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