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Martínez-Rodríguez S, Friaza V, Girón-Moreno RM, Gallego EQ, Salcedo-Posadas A, Figuerola-Mulet J, Solé-Jover A, Campano E, Morilla R, Calderón EJ, Medrano FJ, Horra CDL. Fungal microbiota dynamics and its geographical, age and gender variability in patients with cystic fibrosis. Clin Microbiol Infect 2022; 29:539.e1-539.e7. [PMID: 36371030 DOI: 10.1016/j.cmi.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES In cystic fibrosis (CF), there is a predisposition to bronchial colonization by potentially pathogenic microorganisms, such as fungi. Our aims were to describe the dynamics of respiratory mycobiota in patients with CF and to evaluate the geographic, age and gender variability in its distribution. METHODS Cohort study in which 45 patients with CF from four hospitals in three Spanish cities were followed up during a 1-year period, obtaining spontaneous sputum samples every 3 to 6 months. Fungal microbiota were characterized by Internal Transcribed Spacer sequencing and Pneumocystis jirovecii was identified by nested PCR in a total of 180 samples. RESULTS The presence of fungi were detected in 119 (66.11%) of the 180 samples and in 44 (97.8%) of the 45 patients: 19 were positive and 1 negative throughout all follow-ups and the remaining 25 presented alternation between positive and negative results. A total of 16 different genera were identified, with Candida spp. (50/180, 27.78%) and Pneumocystis spp. (44/180, 24.44%) being the most prevalent ones. The distribution of fungal genera was different among the evaluated centres (p < 0.05), by age (non-adults aged 6-17 years vs. adults aged ≥18 years) (p < 0.05) and by gender (p < 0.05). DISCUSSION A high prevalence of fungal respiratory microbiota in patients with CF was observed, whose dynamics are characterized by the existence of multiple cycles of clearance and colonization, reporting the existence of geographic, age and gender variability in the distribution of fungal genera in this disease.
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Affiliation(s)
- Sara Martínez-Rodríguez
- Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen del Rocío/CSIC/ Universidad de Sevilla), Seville, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Spain
| | - Vicente Friaza
- Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen del Rocío/CSIC/ Universidad de Sevilla), Seville, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Rosa M Girón-Moreno
- Unidad de Fibrosis Quística-Bronquiectasias, Instituto de Investigación Sanitaria de La Princesa, Madrid
| | - Esther Quintana Gallego
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Joan Figuerola-Mulet
- Servicio de Pediatría, Hospital Universitari Son Espases, Balearic Islands Health Research Institute (IdISBa), Palma de Mallorca, Spain
| | - Amparo Solé-Jover
- Unidad de Trasplante Pulmonar y Fibrosis Quística. Universitat de Valencia, Hospital Universitario La Fe, Valencia, Spain
| | - Elena Campano
- Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen del Rocío/CSIC/ Universidad de Sevilla), Seville, Spain
| | - Ruben Morilla
- Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen del Rocío/CSIC/ Universidad de Sevilla), Seville, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Departamento de Enfermería, Universidad de Sevilla, Spain
| | - Enrique J Calderón
- Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen del Rocío/CSIC/ Universidad de Sevilla), Seville, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Seville, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Spain
| | - Francisco J Medrano
- Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen del Rocío/CSIC/ Universidad de Sevilla), Seville, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain; Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Seville, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Spain.
| | - Carmen de la Horra
- Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen del Rocío/CSIC/ Universidad de Sevilla), Seville, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Kim D, Kim SB, Jeon S, Kim S, Lee KH, Lee HS, Han SH. No Change of Pneumocystis jirovecii Pneumonia after the COVID-19 Pandemic: Multicenter Time-Series Analyses. J Fungi (Basel) 2021; 7:jof7110990. [PMID: 34829277 PMCID: PMC8624436 DOI: 10.3390/jof7110990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022] Open
Abstract
Consolidated infection control measures imposed by the government and hospitals during COVID-19 pandemic resulted in a sharp decline of respiratory viruses. Based on the issue of whether Pneumocystis jirovecii could be transmitted by airborne and acquired from the environment, we assessed changes in P. jirovecii pneumonia (PCP) cases in a hospital setting before and after COVID-19. We retrospectively collected data of PCP-confirmed inpatients aged ≥18 years (N = 2922) in four university-affiliated hospitals between January 2015 and June 2021. The index and intervention dates were defined as the first time of P. jirovecii diagnosis and January 2020, respectively. We predicted PCP cases for post-COVID-19 and obtained the difference (residuals) between forecasted and observed cases using the autoregressive integrated moving average (ARIMA) and the Bayesian structural time-series (BSTS) models. Overall, the average of observed PCP cases per month in each year were 36.1 and 47.3 for pre- and post-COVID-19, respectively. The estimate for residuals in the ARIMA model was not significantly different in the total PCP-confirmed inpatients (7.4%, p = 0.765). The forecasted PCP cases by the BSTS model were not significantly different from the observed cases in the post-COVID-19 (−0.6%, 95% credible interval; −9.6~9.1%, p = 0.450). The unprecedented strict non-pharmacological interventions did not affect PCP cases.
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Affiliation(s)
- Dayeong Kim
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
| | - Sun Bean Kim
- Department of Internal Medicine, Division of Infectious Diseases, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea;
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
| | - Subin Kim
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
| | - Kyoung Hwa Lee
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea;
- Correspondence: (H.S.L.); (S.H.H.)
| | - Sang Hoon Han
- Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea; (D.K.); (S.K.); (K.H.L.)
- Correspondence: (H.S.L.); (S.H.H.)
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