BibTex format

author = {Davies, J and Hughes, D and Rosenthal, M and Cuthbertson, L and ramadan, N and Felton, I and Simmonds, N and Loebinger, M and price, H and Armstrong-James, D and elborn, S and Cookson, W and Moffatt, M},
doi = {10.1016/j.jcf.2022.07.009},
journal = {Journal of Cystic Fibrosis},
title = {An invisible threat? Aspergillus positive cultures and co-infecting bacteria in airway sample},
url = {},
year = {2022}

RIS format (EndNote, RefMan)

AB - BackgroundAspergillus fumigatus (Af) infection is associated with poor lung health in chronic suppurative lung diseases but often goes undetected. We hypothesised that inhibition of Af growth by Pseudomonas aeruginosa (Pa) increases the frequency of false-negative Af culture in co-infected people. Using a substantial group of cystic fibrosis (CF) airway samples, we assessed the relationship between Af and bacterial pathogens, additionally comparing fungal culture with next-generation sequencing.MethodsFrequency of co-culture was assessed for 44,554 sputum/BAL cultures, from 1,367 CF patients between the years 2010–2020. In a subgroup, Internal Transcribed Spacer-2 (ITS2) fungal sequencing was used to determine sequencing-positive, culture-negative (S+/C-) rates.ResultsPa+ samples were nearly 40% less likely (P<0.0001) than Pa- samples to culture Af, an effect that was also seen with some other Gram-negative isolates. This impact varied with Pa density and appeared to be moderated by Staphylococcus aureus co-infection. Sequencing identified Af-S+/C- for 40.1% of tested sputa. Samples with Pa had higher rates of Af-S+/C- (49.3%) than those without (35.7%; RR 1.38 [1.02–1.93], P<0.05). Af-S+/C- rate was not changed by other common bacterial infections. Pa did not affect the S+/C- rates of Candida, Exophiala or Scedosporium.ConclusionsPa/ Af co-positive cultures are less common than expected in CF. Our findings suggest an Af-positive culture is less likely in the presence of Pa. Interpretation of negative cultures should be cautious, particularly in Pa-positive samples, and a companion molecular diagnostic could be useful. Further work investigating mechanisms, alternative detection techniques and other chronic suppurative lung diseases is needed.
AU - Davies,J
AU - Hughes,D
AU - Rosenthal,M
AU - Cuthbertson,L
AU - ramadan,N
AU - Felton,I
AU - Simmonds,N
AU - Loebinger,M
AU - price,H
AU - Armstrong-James,D
AU - elborn,S
AU - Cookson,W
AU - Moffatt,M
DO - 10.1016/j.jcf.2022.07.009
PY - 2022///
SN - 1569-1993
TI - An invisible threat? Aspergillus positive cultures and co-infecting bacteria in airway sample
T2 - Journal of Cystic Fibrosis
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UR -
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ER -