FUNGAL COLONIZATION AND IMMUNE-RESPONSE TO FUNGI IN CYSTIC-FIBROSIS

The prevalence of fungal colonization of the respiratory tract and of related sensitization was investigated in 210 patients with cystic fib rosis, 1 to 36 years old, and results were compared with clinical data . Mycological examination of sputum samples revealed the presence of C andida albicans, Aspergillus fumigatus, Scedosporium apiospermum and A spergillus terreus in 52.4 %, 21.4 %, 3.3 % and 1.9 % of the patients, respectively. Fungal colonization was very uncommon in young children and usually succeeded to bacterial infections. Until now, S. apiosper mum has been exceptionally reported in cystic fibrosis patients and it seems that the use of a medium containing cycloheximide improves its isolation. Serum antibodies to C. albicans, A. fumigatus and S. apiosp ermum were detected in 20 %, 19.1 % and 12.8 % of the patients, respec tively. Only two patients fulfilled the diagnostic criteria for allerg ic bronchopulmonary aspergillosis. The progressive rise in the inciden ce of specific antibodies with increasing age and the correlation betw een the presence of these antibodies and decrease Shwachman-Kulczycki score suggest a contributory role of the fungi in pulmonary damages th rough direct pathogenicity or hypersensitivity mechanisms.