Clinical-biological monitoring of respiratory fungal infections in cystic fibrosis

Although cystic fibrosis affects multiple organs, the prognosis remains dominated by damage to the respiratory system. Respiratory infections affect patients' quality of life and are the main cause of morbidity and mortality in this context. These infections are mainly caused by bacteria, so a great deal of work has been carried out in recent years on bacterial infections, particularly Pseudomonas aeruginosa infections.

This work has led to considerable advances in the treatment and prevention of bacterial infections, resulting in a significant increase in life expectancy (around 40 years today).

However, the continuing increase in life expectancy means that we need to take greater account of the microorganisms involved in these respiratory infections, and in particular the fungi whose frequency in cystic fibrosis has risen steadily as life expectancy has increased. However, little information is currently available about these fungal infections, the species involved, their ecology and the sources of contamination in patients, the clinical consequences of colonisation of the respiratory tract by fungi and the treatment of these infections.

We are therefore continuing our work on improving diagnostic methods for these colonisations/infections, the frequency of which is certainly underestimated due to a lack of knowledge on the part of our clinical and mycological colleagues and the absence of standardisation in the mycological examination of sputum from cystic fibrosis patients, as well as in other tests used to investigate these colonisations/infections.

• Theme 1: Epidemiology
• Theme 2: Ecology
• Theme 3: Improved biological diagnosis
• Theme 4: Pharmacokinetics and pharmacodynamics of antifungal agents