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Toward the Standardization of Mycological Examination of Sputum Samples in Cystic Fibrosis : Results from a French Multicenter Prospective Study

Céline Lafarge 1 Bruno Pontoire 2 Nathalie Cayot 3 Patricia Le Bail 2 Noémie Coron 4 Marc Pihet 5 Emilie Fréalle 6 Yolande Lemeille 7 Claudine Pinel 8 Hervé Pelloux 9 Gilles Gargala 10 Loïc Favennec 11 Isabelle Accoceberry 12 Isabelle Durand-Joly 13 Frédéric Dalle 14 Frédéric Huet 15 Annlyse Fanton 16 Amale Boldron Guy-André Loeuille Philippe Domblides 17 Bérengère Coltey 18 Isabelle Pin 19 Catherine Llerena 20 Françoise Troussier 21 Christine Person 22 Christophe Marguet 23 Nathalie Wizla 24 Caroline Thumerelle 25 Dominique Turck 26 Stéphanie Bui 27 Michael Fayon 28 Alain Duhamel 29 Anne Prévotat 30 Sylvie Leroy 31, 13 Benoit Wallaert 32 Jean-Philippe Bouchara 5 Laurence Delhaes 33, 34, *
* Auteur correspondant
CRCINA - Centre de Recherche en Cancérologie et Immunologie Nantes-Angers
Abstract : Fungal respiratory colonization of cystic fibrosis (CF) patients emerges as a new concern; however, the heterogeneity of mycological protocols limits investigations. We first aimed at setting up an efficient standardized protocol for mycological analysis of CF sputa that was assessed during a prospective, multicenter study: “MucoFong” program (PHRC-06/1902). Sputa from 243 CF patients from seven centers in France were collected over a 15-month period and submitted to a standardized protocol based on 6 semi-selective media. After mucolytic pretreatment, sputa were plated in parallel on cycloheximide-enriched (ACT37), erythritol-enriched (ERY37), benomyl dichloran–rose bengal (BENO37) and chromogenic (CAN37) media incubated at 37 °C and on Sabouraud–chloramphenicol (SAB27) and erythritol-enriched (ERY27) media incubated at 20–27 °C. Each plate was checked twice a week during 3 weeks. Fungi were conventionally identified; time for detection of fungal growth was noted for each species. Fungal prevalences and media performances were assessed; an optimal combination of media was determined using the Chi-squared automatic interaction detector method. At least one fungal species was isolated from 81% of sputa. Candida albicans was the most prevalent species (58.8%), followed by Aspergillus fumigatus (35.4%). Cultivation on CAN37, SAB27, ACT37 and ERY27 during 16 days provided an optimal combination, detecting C. albicans, A. fumigatus, Scedosporium apiospermum complex and Exophiala spp. with sensitivities of 96.5, 98.8, 100 and 100%. Combination of these four culture media is recommended to ensure the growth of key fungal pathogens in CF respiratory specimens. The use of such consensual protocol is of major interest for merging results from future epidemiological studies.
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Soumis le : mercredi 18 octobre 2017 - 13:03:14
Dernière modification le : mercredi 19 janvier 2022 - 17:08:04



Céline Lafarge, Bruno Pontoire, Nathalie Cayot, Patricia Le Bail, Noémie Coron, et al.. Toward the Standardization of Mycological Examination of Sputum Samples in Cystic Fibrosis : Results from a French Multicenter Prospective Study. Mycopathologia, Springer Verlag, 2018, 183 (1), pp.101-117. ⟨10.1007/s11046-017-0173-1⟩. ⟨hal-01618715⟩



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