Insights into Aspergillus fumigatus Colonization in Cystic Fibrosis and Cross-Transmission between Patients and Hospital Environments.

Autor: Pontes L; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Perini Leme Giordano AL; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Reichert-Lima F; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Gualtieri Beraquet CA; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Leite Pigolli G; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Arai T; Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba 260-0856, Japan., Ribeiro JD; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Gonçalves AC; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Watanabe A; Division of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba 260-0856, Japan., Goldman GH; Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto 14040-903, Brazil., Moretti ML; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil., Zaninelli Schreiber A; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas 13083-887, Brazil.
Jazyk: angličtina
Zdroj: Journal of fungi (Basel, Switzerland) [J Fungi (Basel)] 2024 Jun 29; Vol. 10 (7). Date of Electronic Publication: 2024 Jun 29.
DOI: 10.3390/jof10070461
Abstrakt: Background: Approximately 60% of individuals with cystic fibrosis (CF) are affected by Aspergillus fumigatus infection. This condition is correlated with a decline in lung function and is identified as an independent risk factor contributing to hospital admissions among CF patients. This study investigates the dynamic interplay of A. fumigatus within the context of CF patients, tracing its evolution over time, with a specific emphasis on colonization dynamics.
Methods: An analysis was conducted on 83 sequential A. fumigatus isolates derived from sputum samples of six patients receiving care at a renowned CF hospital in Brazil. Employing microsatellite genotyping techniques, alongside an investigation into cyp 51A gene mutations, this research sheds light on the genetic variations, colonization, and resistance of A. fumigatus within the CF respiratory environment.
Results: Our research findings indicate that CF patients can harbor A. fumigatus strains from the same clonal complexes for prolonged periods. Additionally, we identified that clinical isolates have the potential to spread among patients in the same healthcare facility, evidencing hospital contamination. Two patients who underwent long-term Itraconazole treatment did not show phenotypic resistance. However, one of these patients exhibited mutations in the cyp 51A gene, indicating the need to monitor resistance to azoles in these patients colonized for long periods by A. fumigatus . We also observed co-colonization or co-infection involving multiple genotypes in all patients over time.
Conclusion: This comprehensive examination offers valuable insights into the pathogenesis of A. fumigatus infections in CF patients, potentially shaping future therapeutic strategies and management approaches. This enhanced understanding contributes to our knowledge of A. fumigatus impact on disease progression in individuals with cystic fibrosis. Additionally, the study provides evidence of cross-contamination among patients undergoing treatment at the same hospital.
Databáze: MEDLINE
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