About 18% of young children with cystic fibrosis are returning BAL cultures positive for Aspergillus species although there seems to be no association with FEV1% predicted or with lung function decline into adolescence.
Data from 156 patients in the Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACF BAL) study found Aspergillus at age 5 years was associated with HRCT scores for air trapping but not bronchiectasis.
In contrast, children with positive P. aeruginosa BAL cultures at age 5 years had an increased probability of airway wall thickening and bronchiectasis.
The study authors said the findings might reflect the relatively mild nature of bronchiectasis and the underlying lung disease in this age group.
“Nevertheless, positive Aspergillus BAL cultures at age 5 years were associated with an increased probability of air trapping, which in young children with CF correlates with small airways structural lung disease,” they wrote in Thorax.
And given the increasing incidence of potential pathogens, particularly Aspergillus fumigatus, chest HRCT scans over time were warranted to ascertain any long-term impact of the organism on structural lung injury, they suggested.