P265 Fast-track biomarker “Anti-Exophiala IgG” in suspected Exophiala spp. infection

The melanized dimorphic fungus Exophiala dermatitidis is detected mainly in the respiratory tract of patients with CF. However, how to determine the clinical manifestation and indication for treatment of bronchopulmonary mycosis is difficult and have not been systematically established yet. To conduct a prospective cohort study lasting 12 months. 200 sputum-producing patients with cystic fibrosis who were ≥6 years of age and attended the CF center were included. Serum was analysed with a tailored, indirect in-house ELISA to detect the anti-Exophiala dermatitidis-IgG reaction. Reactivity was detected by measuring absorbance at 450 nm in our laboratory in Brandenburg an der Havel, which was performed by our collaborative partner from Bilbao, Spain (PhD student Leire Martin-Souto). The results of the sputum sample analysis were divided into two groups. One group was culturally positive in sputum Exophiala dermatitidis (>1 sample) and the other culturally negative. The specific IgG response was significantly higher in the Exophiala positive group (p < 0.001). When multiple serum samples from the same patient are available, chronological imaging of all samples allows the immune response, which is associated with both the development of the infection and the efficacy of antifungal therapy, even if patients do not produce sputum which is often seen in CFTRm treated patients.