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Scedosporium apiospermum from airway secretions of children with cystic fibrosis

Abstract number: P1974

Alexandrou-Athanasoulis H., Doudounakis S., Stathi A., Katelari A., Pangalis A.

Objective:Scedosporium apiospermum has recently been included to the fungal agents which may be of clinical importance in patients with cystic fibrosis. Aim of the study: The incidence of airway colonisation/infection by Scedosporium apio-spermum in comparison with clinical data and the MICs of 5 antifungal agents (itraconazole, ketoconazole, voriconazole, posaconazole and gaspofungin) against the isolated species.

Material and Method: Over a twenty three months period (February 2007 – C December 2008) 2770 sputum or deep throat cultures were performed to 393 children (mean age 8.5±3.9 ys) with cystic fibrosis attending our department. For the detection of fungi the Sabouraud dextrose agar (Conda Pronandisa, Spain) with gentamicin was used, incubated at 35°C and examined daily for fungal growth for up to 5 days. The identification of Scedosporium apiospermum was based on the macroscopic and microscopic morphological features in accordance with standard descriptions. The MICs of antifungal agents were determined with the gradient MIC method using E-test strips (75% reduction of growth). C. parapsilosis ATCC 22019 was used as quality control.

Results: Positive for Scedosporium apiospermum were 57 cultures (2.1%) from 9 children (2.3%) (mean age 12.5,±0.5 ys). Five children are constantly colonised and four seem to have a transient colonisation. Seven of them have a very good clinical status (with FEV1 and spirometric findings within normal values) while one has allergic bronchopulmonary disease. The cultures of the last patient have yielded A. fumigatus, Exophialla dermatitidis, C. albicansA. terreus and Cryptococcus laurentis as well. The MICs (mg/L) of 5 antifungal agents were: itraconazole: 0.008–0.5, ketoconazole: 0.0012–0.9, voriconazole: 0.006–0.047, posaconazole: 0.008–geqslant R: gt-or-equal, slanted32 and caspofungin: 0.003–geqslant R: gt-or-equal, slanted32).

Conclusions: 1. The airways surveillance of CF patients should include suitable culture methods for the isolation of Scedosporium apiospermum from sputum cultures. 2. Although the numbers of isolates tested to antifungal agents are low, it seems that voriconazole is the most active antifungal agent against Scedosporium apiospermum.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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