Exploring the clinical and inflammatory impact of Pseudomonas Aeruginosa and Aspergillus Fumigatus co-infection in Cystic Fibrosis

The microbial airway environment is a complex polymicrobial environment, however the role of chronic co-infection of the common pathogens, Pseudomonas aeruginosa (Pa) and Aspergillus fumigatus (Afu), in the progression of lung disease is poorly understood. This study investigated the clinical impacts and the inflammatory, proteomic and microbiological consequences of chronic Pa/Afu coinfection. <br><br>Methods <br>An observational prospective cohort study was conducted across regional CF adult and paediatric centres.

Participants (104) were stratified into four infection groups: Pa/Afu co-infection (Pa+/Afu+), Pa mono-infection (Pa+/Afu-), Afu mono-infection (Pa-/Afu+), neither Pa nor Afu infection (Pa-/Afu-). Clinical parameters, lung function, inflammatory and proteomic biomarkers and microbiological data were assessed at baseline and at 12-month follow-up, including responses to Kaftrio (Elexacaftor/Tezacaftor/Ivacaftor) in the follow up analysis. <br><br>Results <br>Co-infected (Pa+/Afu+) patients demonstrated a distinct clinical and inflammatory profile, characterised by steeper longitudinal lung function decline, increased frequency of pulmonary exacerbations (PEx), and the need for extended duration of antibiotic treatment.