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• W4304084211 abstract "SESSION TITLE: Not the Normal Host: Infections Still MatterSESSION TYPE: Rapid Fire Original InvPRESENTED ON: 10/17/2022 12:15 pm - 1:15 pmPURPOSE: Cystic fibrosis (CF) leads to multi-system morbidity, but progressive respiratory decline from infection and inflammation remains a primary cause of hospitalization and premature death. Therefore, patients with CF are often treated with broad spectrum antimicrobials with minimal regard for maintaining a healthy respiratory microbiome. Recent studies suggest a relationship between having CF with low microbiota diversity and worsened lung function. The significance of certain respiratory colonizers, including Trichosporon, remains unclear, and consequently treatment guidelines are lacking. Our study evaluates risk factors and outcomes related to Trichosporon colonization among patients with CF.METHODS: Using the Military Healthcare System database, we identified patients with CF who were <26 years old and followed between 2012 and 2017 across 6 CF centers. All available respiratory culture data was collected on these patients. Trichosporon colonized patients (cases) were identified as those with isolation on ≥3 cultures over 12 months. Multiple comparisons were performed between cases and those without Trichosporon isolated (controls) to evaluate for any associations with developing Trichosporon colonization. Cases were matched to controls by minimizing the Mahalanobis distance between the patients’ age, best annual BMI and FEV1, and annual percentage of cultures positive for Pseudomonas aeruginosa at the year preceding Trichosporon isolation. We compared continuous demographic variables and microbiota diversity using paired t-tests for cases and matched controls.RESULTS: We identified 220 patients with CF <26 years old; 84 of these patients were followed for at least 4 years. Trichosporon was isolated in 13 patients including 7 who were colonized; the remaining 71 were used as controls and were eligible for matching. Diabetes was observed in 3 (43%) cases versus 12 (17%) controls (P=0.09). Among cases, 6 were followed for at least 3 years following isolation of Trichosporon and all remained colonized. Compared to matched controls, microbiota diversity was lower in cases at all time points after Trichosporon colonization. We were underpowered to evaluate changes in coinfections over time. BMI and FEV1 remained stable with no significant differences noted between cases and matched controls.CONCLUSIONS: Among patients with CF, Trichosporon isolation often predicts chronic colonization. Trichosporon colonization may be associated with lower microbiota diversity. We did not demonstrate any association with clinical morbidity related to Trichosporon colonization. Our findings highlight the need for population-scale analysis of the clinical significance of Trichosporon colonization in patients with CF.CLINICAL IMPLICATIONS: Continued analysis of the respiratory microbiome and clinical impact of certain respiratory colonizers in patients with CF can help guide more appropriate treatment protocols.DISCLOSURES: No relevant relationships by Jason CabootNo relevant relationships by Uyen ChuNo relevant relationships by Zachary ColburnNo relevant relationships by Patrick HickeyNo relevant relationships by Aimee RambieNo relevant relationships by Rebecca SainatoNo relevant relationships by Joshua Sakai SESSION TITLE: Not the Normal Host: Infections Still Matter SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: Cystic fibrosis (CF) leads to multi-system morbidity, but progressive respiratory decline from infection and inflammation remains a primary cause of hospitalization and premature death. Therefore, patients with CF are often treated with broad spectrum antimicrobials with minimal regard for maintaining a healthy respiratory microbiome. Recent studies suggest a relationship between having CF with low microbiota diversity and worsened lung function. The significance of certain respiratory colonizers, including Trichosporon, remains unclear, and consequently treatment guidelines are lacking. Our study evaluates risk factors and outcomes related to Trichosporon colonization among patients with CF. METHODS: Using the Military Healthcare System database, we identified patients with CF who were <26 years old and followed between 2012 and 2017 across 6 CF centers. All available respiratory culture data was collected on these patients. Trichosporon colonized patients (cases) were identified as those with isolation on ≥3 cultures over 12 months. Multiple comparisons were performed between cases and those without Trichosporon isolated (controls) to evaluate for any associations with developing Trichosporon colonization. Cases were matched to controls by minimizing the Mahalanobis distance between the patients’ age, best annual BMI and FEV1, and annual percentage of cultures positive for Pseudomonas aeruginosa at the year preceding Trichosporon isolation. We compared continuous demographic variables and microbiota diversity using paired t-tests for cases and matched controls. RESULTS: We identified 220 patients with CF <26 years old; 84 of these patients were followed for at least 4 years. Trichosporon was isolated in 13 patients including 7 who were colonized; the remaining 71 were used as controls and were eligible for matching. Diabetes was observed in 3 (43%) cases versus 12 (17%) controls (P=0.09). Among cases, 6 were followed for at least 3 years following isolation of Trichosporon and all remained colonized. Compared to matched controls, microbiota diversity was lower in cases at all time points after Trichosporon colonization. We were underpowered to evaluate changes in coinfections over time. BMI and FEV1 remained stable with no significant differences noted between cases and matched controls. CONCLUSIONS: Among patients with CF, Trichosporon isolation often predicts chronic colonization. Trichosporon colonization may be associated with lower microbiota diversity. We did not demonstrate any association with clinical morbidity related to Trichosporon colonization. Our findings highlight the need for population-scale analysis of the clinical significance of Trichosporon colonization in patients with CF. CLINICAL IMPLICATIONS: Continued analysis of the respiratory microbiome and clinical impact of certain respiratory colonizers in patients with CF can help guide more appropriate treatment protocols. DISCLOSURES: No relevant relationships by Jason Caboot No relevant relationships by Uyen Chu No relevant relationships by Zachary Colburn No relevant relationships by Patrick Hickey No relevant relationships by Aimee Rambie No relevant relationships by Rebecca Sainato No relevant relationships by Joshua Sakai" @default.
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• W4304084211 date "2022-10-01" @default.
• W4304084211 modified "2023-09-23" @default.
• W4304084211 title "TRICHOSPORON COLONIZATION IN PATIENTS WITH CYSTIC FIBROSIS: TO TREAT OR NOT TO TREAT? THAT IS THE CLINICAL QUESTION" @default.
• W4304084211 doi "https://doi.org/10.1016/j.chest.2022.08.313" @default.
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