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High recovery rate of Exophiala dermatitidis in the airways of cystic fibrosis patients is associated with pancreatic insufficiency.

Journal article
Authors Nahid Kondori
Marita Gilljam
Anders Lindblad
Bodil Jönsson
Edward R.B. Moore
Christine Wennerås
Published in Journal of clinical microbiology
Volume Mar (49)
Issue 3
Pages 1004-9
ISSN 1098-660X
Publication year 2011
Published at Institute of Medicine, Department of Internal Medicine
Institute of Clinical Sciences, Department of Pediatrics
Institute of Biomedicine, Department of Infectious Medicine
Pages 1004-9
Language en
Keywords clinical mycology, Exophiala dermatitidis, cystic fibrosis,
Subject categories Molecular biology, Microbiology, Biological Systematics, Microbiology, Infectious Medicine, Respiratory Medicine and Allergy


The black pigmented fungus, Exophiala dermatitidis is considered to be a harmless colonizer of the airways of cystic fibrosis (CF) patients. The aim of this study was to establish the recovery rate of E. dermatitidis in respiratory specimens of CF patients, transplant recipients and subjects with other respiratory disorders in Sweden. Secondly, we wished to determine if particular clinical traits were associated with E. dermatitidis colonization of the airways, and the antifungal susceptibility profiles of Exophiala strains. Sputum and bronchoalveolar lavage samples (n=492) derived from 275 patients were investigated. E. dermatitidis was isolated in respiratory specimens of 19% (18/97) of the CF patients but in none of the other patient categories. All isolates were recovered after 6-25 days of incubation on erythritol-chloramphenicol (ECA) medium. Morphological and genetic analyses confirmed species identity. Pancreatic insufficiency was positively associated with the presence of E. dermatitidis in sputum samples (P= 0.0198). Antifungal susceptibility tests demonstrated that voriconazole and posaconazole had the lowest MICs against E. dermatitidis. To conclude, E. dermatitidis is a frequent colonizer of the respiratory tract of CF patients in Sweden, and appears to be associated with more advanced disease. Whether E. dermatitidis is pathogenic or not remains to be elucidated.

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