Conclusions
We found associations between frequent fungal detection and bacterial co-infection with P. aeruginosa and S. maltophilia , but not MSSA or MRSA in people with CF. In those with a diagnosis of ABPA, frequent fungal detection was associated with worse clinical outcomes with high rates of comorbidities, co-infections with pathogenic bacteria, and worse lung disease. However, we did not detect a similar association between fungal detection and clinical outcomes when controlling for ABPA diagnosis. Future prospective studies are needed to determine the relationship between fungal infection, bacterial co-infections and development of ABPA.