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There are several Aspergillus: fumigatus, niger, flavus ... Are some of them more dreadful than others? In case of contamination, is antibiotic treatment systematic?
Thank you.
The presence of filamentous fungi like Aspergillus is very common in patients with cystic fibrosis when it is specifically sought, it is called lung colonization with aspergillus.
In a study conducted in 201 adult patients (Medical Mycology 2010, 48 (suppl 1): S32-S36), we found Aspergillus fumigatus in 56% of the patients. The presence of non-fumigatus Aspergillus was less frequent, in 10% of the patients: Aspergillus flavus (3.4%), Aspergillus Niger (2.9%), Aspergillus nidulans (1.9%) Aspergillus versicolor (0.9%) and Aspergillus terreus (0.9%).
We did not identify any difference in virulence between these aspergillus species, but there are still many uncertainties regarding the impact of these fungi in patients with CF and indications of treatment .
When there is only a contamination, treatment with antifungal antibiotics is not systematic. Treatment should be discussed when there are signs of respiratory infection caused by fungus, or in some cases of allergic bronchopulmonary aspergillosis (ABPA) in addition to corticosteroid treatment.
If treatment is necessary, it is interesting to perform a sensitivity test to identify the sensitivity of Aspergillus to various available antifungal drugs since the discovery of resistance can undermine the effectiveness of certain treatments, regardless of the Aspergillus species.
Best regards.
Dr Dominique Hubert