Prevalence of Aspergillus colonization and sensitization in patients of
cystic fibrosis
Abstract
Background: Aspergillus fumigatus and other fungal species are common
pathogens isolated in CF patients and they lead to a variety of diseases
like ABPA and invasive aspergillosis. Aims and Objectives: To study the
prevalence of Aspergillus colonization, sensitization and ABPA in our
cohort of CF patients. Also, to study the various risk factors for
Aspergillus colonization and ABPA in these patients. Methodology: This
was a observational study in which 30 patients of cystic fibrosis
between 0 to 18 years were enrolled visiting a tertiary care hospital in
north India during January 2019 till December 2020. Data was collected
on pre-structured proforma on cough swab and sputum c/s for bacteria and
fungus, skin prick test for Aspergillus fumigatus, total IgE,
Aspergillus specific IgE, Aspergillus specific IgG, galactomannan and
CXR. Prevalence of Aspergillus colonization, sensitization and ABPA was
calculated, Odds ratio for all the postulated risk factors for
Aspergillus colonization and ABPA were calculated and further Chi square
test was applied to check association of ABPA with pulmonary
exacerbation. Results: Patients enrolled were between the age group of 4
months till 18 years of age with the median age being 4.75 years (IQR:
2.25 -11.75). 16.67% (n=5), 36.67% (n=11) of the patients enrolled in
our study were colonized and sensitized with Aspergillus fumigatus
respectively. While, 23.34% (n=7) of the patients had ABPA. We found
positive association of Aspergillus colonization with multiple risk
factors under study, in the following order of decreasing odds ratio,
inhaled antibiotics (OR: 4.75) followed by use of azithromycin (OR:
3.5), inhaled corticosteroids (OR: 2.6), and atopy (OR: 1.3).
Conclusion: Aspergillus fumigatus is a common colonizer in patients of
cystic fibrosis (16.67%), and can lead to an inflammatory response and
ABPA (23.34%). Use of azithromycin, inhaled antibiotics, inhaled
corticosteroids and atopy increases the chances of Aspergillus
colonization.