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Candida glabrata

Dear ladies and gentlemen,
Candida glabrata has been found for the first time in my airway secretions (CF, 48 years old, female, FEV1 54%, MRGN3/4). I found a study from the university of Tuebingen, Germany from 2016 that drew the conclusion that a chronic or intermittend colonization can lead to a significant loss of lung function. As the fungus is hardly sensitive to Itraconazol, I am a bit worried.
Is there any clinical experience on this topic? What kind of symptoms does it cause? How can it be differentiated from a bacterial infection? What kind of treatment is possible?
Many thanks for your answer,
Dear questioner,
the retrospective study from Tuebingen is limitated concerining its statements on the relevance of Candida glabrata, as only 1,7% of the included patients had a chronic colonization with C. glabrata. The authors pointed on the low number of CF patients with C. glabrata in their discussion.
C. albicans has been described to be protective in this study. It is possible, that patients with C. glabrata got more frequently Itraconazole and therefore a selction of C. glabrata led to the more frequent finding of this fungus in these "severerly ill" patients.
Until now, no pathogenic mechanism of Candida species has been described in CF patients, even if Candida is frequently found in the sputum. Especially there is a lack of study results concering the interaction of bacteria and fungi in the CF lung. I regard the finding of Candida glabrata as not to be significant for the course of the illness, so does your CF center. Typical symtoms for its colonization cannot be described.
Best regards,
Jörg Steinmann