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

Noémie Coron 1, 2, 3 Marc Pihet 1 Emilie Fréalle 4 Yolande Lemeille 5, 6 Claudine Pinel 5, 6 Hervé Pelloux 5, 6 Gilles Gargala 7 Loïc Favennec 7 Isabelle Accoceberry 3, 8 Isabelle Durand-Joly 9 Frédéric Dalle 10 Frédéric Huet 10, 11 Annlyse Fanton 11, 10 Amale Boldron 9 Guy-André Loeuille 11, 9 Philippe Domblides 12, 3 Bérengère Coltey 13, 5 Isabelle Pin 5 Catherine Llerena 5 Françoise Troussier 1 Christine Person 1 Christophe Marguet 14, 15 Nathalie Wizla 16 Caroline Thumerelle 16 Dominique Turck 16 Stéphanie Bui 12, 17, 3 Michael Fayon 12, 17, 3 Alain Duhamel 18 Anne Prévotat 16 Benoit Wallaert 16 Sylvie Leroy 19, 20, 21 Jean-Philippe Bouchara 1 Laurence Delhaes 22, 2, * 
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 : mardi 18 octobre 2022 - 04:22:34



Noémie Coron, Marc Pihet, Emilie Fréalle, Yolande Lemeille, Claudine Pinel, et al.. Toward the Standardization of Mycological Examination of Sputum Samples in Cystic Fibrosis : Results from a French Multicenter Prospective Study. Mycopathologia, 2018, 183 (1), pp.101-117. ⟨10.1007/s11046-017-0173-1⟩. ⟨hal-01618715⟩



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