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首页> 外文期刊>Journal of Clinical Microbiology >Use of Selective Fungal Culture Media Increases Rates of Detection of Fungi in the Respiratory Tract of Cystic Fibrosis Patients
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Use of Selective Fungal Culture Media Increases Rates of Detection of Fungi in the Respiratory Tract of Cystic Fibrosis Patients

机译：使用选择性真菌培养基可提高囊性纤维化患者呼吸道中真菌的检出率

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The prevalence of fungi in the respiratory tracts of cystic fibrosis (CF) patients has risen. However, fungal surveillance is not routinely performed in most clinical centers in the United States, which may lead to an underestimation of the true prevalence of the problem. We conducted a prospective study comparing the rates of detection for clinically important fungi (CIF), defined as Aspergillus, Scedosporium, and Trichosporon species and Exophiala dermatitidis, in CF sputa using standard bacterial and selective fungal culture media, including Sabouraud dextrose agar with gentamicin (SDA), inhibitory mold agar (IMA), and brain heart infusion (BHI) agar with chloramphenicol and gentamicin. We described the prevalence of these fungi in an adult CF population. A total of 487 CF respiratory samples were collected from 211 unique participants. CIF were detected in 184 (37.8) samples. Only 26.1 of CIF-positive samples were detected in bacterial culture medium, whereas greater rates of detection for fungi were found in IMA (65.8; P < 0.001), in SDA (at 30 degrees C, 64.7; P = 0.005), and in BHI agar (63.0; P = 0.001). The prevalences of Aspergillus and Scedosporium species were 40.8 and 5.2, respectively, which are greater than the nationally reported prevalence numbers of 20.4 and 1.9. Selective fungal culture media and longer incubation periods yielded higher rates of detection for CIF in CF sputum samples compared with that detected in bacterial culture medium, resulting in an underdetection of fungi by bacterial culture alone. The prevalence of fungi in CF may be better estimated by using selective fungal culture media, and this may translate to important clinical decisions.
机译：囊性纤维化 （CF） 患者呼吸道中真菌的患病率有所上升。然而，在美国的大多数临床中心，真菌监测并不常规，这可能导致低估该问题的真实患病率。我们进行了一项前瞻性研究，比较了使用标准细菌和选择性真菌培养基（包括含有庆大霉素 （SDA）、抑制性霉菌琼脂 （IMA） 和含有氯霉素和庆大霉素的脑心输注 （BHI） 琼脂）在 CF 痰液中临床重要真菌 （CIF） 的检出率。我们描述了这些真菌在成年CF人群中的流行情况。从 211 名独特的参与者中共收集了 487 份 CF 呼吸道样本。在184个（37.8%）样本中检测到CIF。在细菌培养基中仅检测到26.1%的CIF阳性样品，而在IMA中检测到真菌的检出率更高（65.8%;P < 0.001）、SDA（30°C时，64.7%;P = 0.005）和BHI琼脂（63.0%;P = 0.001）。曲霉菌和孢子菌的患病率分别为40.8%和5.2%，高于全国报告的20.4%和1.9%的患病率。与细菌培养基相比，选择性真菌培养基和更长的孵育期对CF痰样品CIF的检出率更高，导致仅通过细菌培养对真菌的检出不足。通过使用选择性真菌培养基可以更好地估计 CF 中真菌的患病率，这可能会转化为重要的临床决策。

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