Atypical Mycobacterial and Fungal Infections in Cystic Fibrosis

ABSTRACT

Nontuberculous mycobacteria (NTM) and fungi are prevalent in the sputum of cystic fibrosis patients and are increasingly recognized to cause clinically significant disease. In both instances the organisms are ubiquitous within the environment making exposure common, although specific risk factors that contribute to active pulmonary infection have not been identified. A consistent and aggressive approach to screening for NTM and fungi within the cystic fibrosis airway is likely indicated, especially in the setting of clinical deterioration despite standard antipseudomonal therapies.

KEYWORDS

Cystic fibrosis - nontuberculous mycobacteria - fungi - lung disease

REFERENCES

• 1 Rowe S M, Miller S, Sorscher E J. Cystic fibrosis.  N Engl J Med. 2005;  352 1992-2001
• 2 Wolinsky E. Nontuberculous mycobacteria and associated diseases.  Am Rev Respir Dis. 1979;  119 107-159
• 3 Guay D R. Nontuberculous mycobacterial infections.  Ann Pharmacother. 1996;  30 819-830
• 4 Olivier K N, Weber D J, Wallace Jr R J Nontuberculous Mycobacteria in Cystic Fibrosis Study Group et al. Nontuberculous mycobacteria, I: Multicenter prevalence study in cystic fibrosis. [see comment].  Am J Respir Crit Care Med. 2003;  167 828-834
• 5 Olivier K N, Yankaskas J R, Knowles M R. Nontuberculous mycobacterial pulmonary disease in cystic fibrosis.  Semin Respir Infect. 1996;  11 272-284
• 6 Sexton P, Harrison A C. Susceptibility to nontuberculous mycobacterial lung disease.  Eur Respir J. 2008;  31 1322-1333
• 7 Fowler S J, French J, Screaton N J et al.. Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics.  Eur Respir J. 2006;  28 1204-1210
• 8 Torrens J K, Dawkins P, Conway S P, Moya E. Non-tuberculous mycobacteria in cystic fibrosis.  Thorax. 1998;  53 182-185
• 9 Chalermskulrat W, Sood N, Neuringer I P et al.. Non-tuberculous mycobacteria in end stage cystic fibrosis: implications for lung transplantation.  Thorax. 2006;  61 507-513
• 10 Griffith D E, Aksamit T, Brown-Elliott B A et al.. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases.  Am J Respir Crit Care Med. 2007;  175 367-416
• 11 Kent P, Kubica G. Public health mycobacteriology: a guide for the level III laboratory. In: Services UDoHaH, ed. Centers for Disease Control and Prevention. 1985
• 12 Whittier S, Hopfer R L, Knowles M R, Gilligan P H. Improved recovery of mycobacteria from respiratory secretions of patients with cystic fibrosis.  J Clin Microbiol. 1993;  31 861-864
• 13 Whittier S, Olivier K, Gilligan P, Knowles M, Della-Latta P. The Nontuberculous Mycobacteria in Cystic Fibrosis Study Group . Proficiency testing of clinical microbiology laboratories using modified decontamination procedures for detection of nontuberculous mycobacteria in sputum samples from cystic fibrosis patients.  J Clin Microbiol. 1997;  35 2706-2708
• 14 Bange F C, Kirschner P, Böttger E C. Recovery of mycobacteria from patients with cystic fibrosis.  J Clin Microbiol. 1999;  37 3761-3763
• 15 Coelho A G, Zamarioli L A, Reis C M, Nascimento A C, Rodrigues J dosS. Gene probes versus classical methods in the identification of mycobacteria.  J Bras Pneumol. 2008;  34 922-926
• 16 Peter-Getzlaff S, Lüthy J, Böddinghaus B, Böttger E C, Springer B. Development and evaluation of a molecular assay for detection of nontuberculous mycobacteria by use of the cobas amplicor platform.  J Clin Microbiol. 2008;  46 4023-4028
• 17 Gilljam M, Berning S E, Peloquin C A, Strandvik B, Larsson L O. Therapeutic drug monitoring in patients with cystic fibrosis and mycobacterial disease.  Eur Respir J. 1999;  14 347-351
• 18 Chatte G, Panteix G, Perrin-Fayolle M, Pacheco Y. Aerosolized interferon gamma for Mycobacterium avium-complex lung disease.  Am J Respir Crit Care Med. 1995;  152 1094-1096
• 19 Colsky A S, Hanly A, Elgart G, Kerdel F A. Treatment of refractory disseminated Mycobacterium abscessus infection with interferon gamma therapy.  Arch Dermatol. 1999;  135 125-127
• 20 Condos R, Rom W N, Schluger N W. Treatment of multidrug-resistant pulmonary tuberculosis with interferon-gamma via aerosol.  Lancet. 1997;  349 1513-1515
• 21 Moss R B, Mayer-Hamblett N, Wagener J et al.. Randomized, double-blind, placebo-controlled, dose-escalating study of aerosolized interferon gamma-1b in patients with mild to moderate cystic fibrosis lung disease.  Pediatr Pulmonol. 2005;  39 209-218
• 22 Camargos P, Le Bourgeois M, Revillon Y et al.. Lung resection in cystic fibrosis: a survival analysis.  Pediatr Pulmonol. 2008;  43 72-76
• 23 Häusler M, Franke E, Wendt G, Kentrup H, Döhmen H, Kusenbach G. Pneumonectomy in cystic fibrosis.  Pediatr Pulmonol. 1999;  28 376-379
• 24 Smith M B, Hardin Jr W D, Dressel D A, Beckerman R C, Moynihan P C. Predicting outcome following pulmonary resection in cystic fibrosis patients.  J Pediatr Surg. 1991;  26 655-659
• 25 Forslöw U, Geborek A, Hjelte L, Petrini B, Heurlin N. Early chemotherapy for non-tuberculous mycobacterial infections in patients with cystic fibrosis.  Acta Paediatr. 2003;  92 910-915
• 26 Olivier K N, Weber D J, Lee J H Nontuberculous Mycobacteria in Cystic Fibrosis Study Group et al. Nontuberculous mycobacteria, II: Nested-cohort study of impact on cystic fibrosis lung disease. [see comment].  Am J Respir Crit Care Med. 2003;  167 835-840
• 27 Bartz R R, Love R B, Leverson G E, Will L R, Welter D L, Meyer K C. Pre-transplant mechanical ventilation and outcome in patients with cystic fibrosis.  J Heart Lung Transplant. 2003;  22 433-438
• 28 Sanguinetti M, Ardito F, Fiscarelli E et al.. Fatal pulmonary infection due to multidrug-resistant Mycobacterium abscessus in a patient with cystic fibrosis.  J Clin Microbiol. 2001;  39 816-819
• 29 Taylor J L, Palmer S M. Mycobacterium abscessus chest wall and pulmonary infection in a cystic fibrosis lung transplant recipient.  J Heart Lung Transplant. 2006;  25 985-988
• 30 Flume P A, Egan T M, Paradowski L J, Detterbeck F C, Thompson J T, Yankaskas J R. Infectious complications of lung transplantation: impact of cystic fibrosis.  Am J Respir Crit Care Med. 1994;  149 1601-1607
• 31 Navarro J, Rainisio M, Harms H K et al.. Factors associated with poor pulmonary function: cross-sectional analysis of data from the ERCF. European Epidemiologic Registry of Cystic Fibrosis.  Eur Respir J. 2001;  18 298-305
• 32 Foweraker J. Recent advances in the microbiology of respiratory tract infection in cystic fibrosis.  Br Med Bull. 2009;  89 93-110
• 33 Bakare N, Rickerts V, Bargon J, Just-Nübling G. Prevalence of Aspergillus fumigatus and other fungal species in the sputum of adult patients with cystic fibrosis.  Mycoses. 2003;  46 19-23
• 34 Stevens D A, Moss R B, Kurup V P Participants in the Cystic Fibrosis Foundation Consensus Conference et al. Allergic bronchopulmonary aspergillosis in cystic fibrosis—state of the art: Cystic Fibrosis Foundation Consensus Conference.  Clin Infect Dis. 2003;  37(Suppl 3) S225-S264
• 35 Nelson L A, Callerame M L, Schwartz R H. Aspergillosis and atopy in cystic fibrosis.  Am Rev Respir Dis. 1979;  120 863-873
• 36 Cimon B, Carrère J, Vinatier J F, Chazalette J P, Chabasse D, Bouchara J P. Clinical significance of Scedosporium apiospermum in patients with cystic fibrosis.  Eur J Clin Microbiol Infect Dis. 2000;  19 53-56
• 37 Vázquez-Tsuji O, Campos Rivera T, Rondán Zárate A, Mirabal García M. Endobronchitis by Scedosporium apiospermum in a child with cystic fibrosis.  Rev Iberoam Micol. 2006;  23 245-248
• 38 Horre R, Schaal K P, Siekmeier R, Sterzik B, de Hoog G S, Schnitzler N. Isolation of fungi, especially Exophiala dermatitidis, in patients suffering from cystic fibrosis. A prospective study.  Respiration. 2004;  71 360-366
• 39 Kusenbach G, Skopnik H, Haase G, Friedrichs F, Döhmen H. Exophiala dermatitidis pneumonia in cystic fibrosis.  Eur J Pediatr. 1992;  151 344-346
• 40 Diemert D, Kunimoto D, Sand C, Rennie R. Sputum isolation of Wangiella dermatitidis in patients with cystic fibrosis.  Scand J Infect Dis. 2001;  33 777-779
• 41 Shoseyov D, Brownlee K G, Conway S P, Kerem E. Aspergillus bronchitis in cystic fibrosis.  Chest. 2006;  130 222-226
• 42 Rüping M J, Vehreschild J J, Cornely O A. Patients at high risk of invasive fungal infections: when and how to treat.  Drugs. 2008;  68 1941-1962
• 43 Burns J L, Van Dalfsen J M, Shawar R M et al.. Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis.  J Infect Dis. 1999;  179 1190-1196
• 44 Hogan D A, Kolter R. Pseudomonas–Candida interactions: an ecological role for virulence factors.  Science. 2002;  296 2229-2232
• 45 Agarwal R, Nath A, Aggarwal A N, Gupta D, Chakrabarti A. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with acute severe asthma in a respiratory intensive care unit in North India.  Mycoses. 2009 Jan 24;  , [Epub ahead of print]
• 46 Denning D W, O’Driscoll B R, Powell G et al.. Randomized controlled trial of oral antifungal treatment for severe asthma with fungal sensitization: The Fungal Asthma Sensitization Trial (FAST) study.  Am J Respir Crit Care Med. 2009;  179 11-18
• 47 Máiz L, Cuevas M, Quirce S et al.. Serologic IgE immune responses against Aspergillus fumigatus and Candida albicans in patients with cystic fibrosis.  Chest. 2002;  121 782-788
• 48 Hartl D, Latzin P, Zissel G, Krane M, Krauss-Etschmann S, Griese M. Chemokines indicate allergic bronchopulmonary aspergillosis in patients with cystic fibrosis.  Am J Respir Crit Care Med. 2006;  173 1370-1376
• 49 Travis L B, Roberts G D, Wilson W R. Clinical significance of Pseudallescheria boydii: a review of 10 years’ experience.  Mayo Clin Proc. 1985;  60 531-537
• 50 Tadros T S, Workowski K A, Siegel R J, Hunter S, Schwartz D A. Pathology of hyalohyphomycosis caused by Scedosporium apiospermum (Pseudallescheria boydii): an emerging mycosis.  Hum Pathol. 1998;  29 1266-1272
• 51 Guignard S, Hubert D, Dupont B et al.. Multifocal Scedosporium apiospermum spondylitis in a cystic fibrosis patient.  J Cyst Fibros. 2008;  7 89-91
• 52 Symoens F, Knoop C, Schrooyen M et al.. Disseminated Scedosporium apiospermum infection in a cystic fibrosis patient after double-lung transplantation.  J Heart Lung Transplant. 2006;  25 603-607
• 53 Haase G, Skopnik H, Groten T, Kusenbach G, Posselt H G. Long-term fungal cultures from sputum of patients with cystic fibrosis.  Mycoses. 1991;  34 373-376
• 54 Haase G, Skopnik H, Kusenbach G. Exophiala dermatitidis infection in cystic fibrosis.  Lancet. 1990;  336 188-189
• 55 Lipp H P. Antifungal agents—clinical pharmacokinetics and drug interactions.  Mycoses. 2008;  51(Suppl 1) 7-18
• 56 Herbrecht R, Denning D W, Patterson T F Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis.  N Engl J Med. 2002;  347 408-415
• 57 Walsh T J, Anaissie E J, Denning D W Infectious Diseases Society of America et al. Treatment of aspergillosis: clinical practice guidelines of the Infectious Diseases Society of America.  Clin Infect Dis. 2008;  46 327-360
• 58 Wark P, Wilson A W, Gibson P G. Azoles for allergic bronchopulmonary aspergillosis associated with asthma.  Cochrane Database Syst Rev. 2001;  (4) CD001108 , Review. Update in: Cochrane Database Syst Rev 2003;(3):CD001108
• 59 Nagappan V, Deresinski S. Reviews of anti-infective agents: posaconazole: a broad-spectrum triazole antifungal agent.  Clin Infect Dis. 2007;  45 1610-1617
• 60 Fisher B T, Zaoutis T E. Treatment of invasive candidiasis in immunocompromised pediatric patients.  Paediatr Drugs. 2008;  10 281-298
• 61 Kauffman C A, Carver P L. Update on echinocandin antifungals.  Semin Respir Crit Care Med. 2008;  29 211-219
• 62 Marr K A, Boeckh M, Carter R A, Kim H W, Corey L. Combination antifungal therapy for invasive aspergillosis.  Clin Infect Dis. 2004;  39 797-802
• 63 Patterson T F, Boucher H W, Herbrecht R European Organization for Research and Treatment of Cancer (EORTC) Invasive Fungal Infections Group (IFIG) et al. Strategy of following voriconazole versus amphotericin B therapy with other licensed antifungal therapy for primary treatment of invasive aspergillosis: impact of other therapies on outcome.  Clin Infect Dis. 2005;  41 1448-1452
• 64 Lass-Flörl C, Mayr A, Perkhofer S et al.. Activities of antifungal agents against yeasts and filamentous fungi: assessment according to the methodology of the European Committee on Antimicrobial Susceptibility Testing.  Antimicrob Agents Chemother. 2008;  52 3637-3641