Prevalence and risk factors for recovery of filamentous fungi in individuals with cystic fibrosis

Background: Filamentous fungi are frequently recovered from respiratory cultures of individuals with CF. Methods: A CF cohort database was utilized to determine filamentous fungal prevalence and risk factors. Results: The prevalence of filamentous fungal isolation increased from 2.0% in 1997 to 28.7% in 2007. The odds of isolating filamentous fungi during a quarter was greater in CF adults [p < 0.001], during chronic oral antibiotic use [p = 0.002] and increased with each 10% drop in FEV₁ percent predicted [p = 0.005], while inhaled corticosteroids surprisingly decreased the likelihood [p = 0.012]. The direction of these effects persisted after excluding individuals with ABPA. A sub-analysis determined older age [p = 0.019] and use of inhaled antibiotics [p = 0.011] were independent risk factors for onset of fungal colonization. Conclusions: This study suggests that isolation of filamentous fungi in CF at JHH has increased and risk factors include older age, decreased lung function, and chronic oral antibiotics.