Antifungal Susceptibility Profile of Cryptic Species of Aspergillus

Alastruey‐Izquierdo, Ana; Alcàzar-Fuoli, Laura; Cuenca‐Estrella, Manuel

doi:10.1007/s11046-014-9775-z

Cited by 123 publications

(118 citation statements)

References 44 publications

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“…This is the first comprehensive study from India characterizing a large number of various Aspergillus species by sequencing and MALDI-TOF MS. An updated species list of the genus Aspergillus by Samson et al (23) (8,9,(24)(25)(26)(27). However, the clinical context has been described in few of these species, and data on antifungal treatment outcome are even more infrequent.…”

Section: Discussionmentioning

confidence: 99%

Identification by Molecular Methods and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry and Antifungal Susceptibility Profiles of Clinically Significant Rare Aspergillus Species in a Referral Chest Hospital in Delhi, India

et al. 2016

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dAspergillus species cause a wide spectrum of clinical infections. Although Aspergillus fumigatus and Aspergillus flavus remain the most commonly isolated species in aspergillosis, in the last decade, rare and cryptic Aspergillus species have emerged in diverse clinical settings. The present study analyzed the distribution and in vitro antifungal susceptibility profiles of rare Aspergillus species in clinical samples from patients with suspected aspergillosis in 8 medical centers in India. Further, a matrix-assisted laser desorption ionization-time of flight mass spectrometry in-house database was developed to identify these clinically relevant Aspergillus species. ␤-Tubulin and calmodulin gene sequencing identified 45 rare Aspergillus isolates to the species level, except for a solitary isolate. They included 23 less common Aspergillus species belonging to 12 sections, mainly in Circumdati, Nidulantes, Flavi, Terrei, Versicolores, Aspergillus, and Nigri. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) identified only 8 (38%) of the 23 rare Aspergillus isolates to the species level. Following the creation of an in-house database with the remaining 14 species not available in the Bruker database, the MALDI-TOF MS identification rate increased to 95%. Overall, high MICs of >2 g/ml were noted for amphotericin B in 29% of the rare Aspergillus species, followed by voriconazole in 20% and isavuconazole in 7%, whereas MICs of >0.5 g/ml for posaconazole were observed in 15% of the isolates. Regarding the clinical diagnoses in 45 patients with positive rare Aspergillus species cultures, 19 (42%) were regarded to represent colonization. In the remaining 26 patients, rare Aspergillus species were the etiologic agent of invasive, chronic, and allergic bronchopulmonary aspergillosis, allergic fungal rhinosinusitis, keratitis, and mycetoma.A spergillus species cause a wide spectrum of clinical infections, ranging from allergic to chronic and life-threatening invasive diseases (1). The most common pathogenic species implicated in aspergillosis are A. fumigatus, A. flavus, A. terreus, and rarely, A. niger. However, in the last decade, several reports have pointed to a shift in the etiology of aspergillosis and highlighted the emergence of cryptic and rare Aspergillus species in various clinical settings in both immunocompromised and immunocompetent hosts (2-4). This shift is mainly linked to the application of multilocus DNA sequence analysis in various studies, leading to the description of previously unknown "cryptic" Aspergillus species (5-7). In two population-based prospective studies in the United States and Spain, the prevalences of cryptic Aspergillus species detected in clinical specimens were found to be 10% and 12%, respectively (8, 9). The molecular analysis of aspergilli collected from the Transplant-Associated Infection Surveillance Network (TRANSNET) from 24 transplant centers throughout the United States revealed that 10% of the isolates associated with invasive aspe...

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Section: Discussionmentioning

confidence: 99%

Identification by Molecular Methods and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry and Antifungal Susceptibility Profiles of Clinically Significant Rare Aspergillus Species in a Referral Chest Hospital in Delhi, India

et al. 2016

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“…The in vitro susceptibility results from our four cases are consistent with previously published cases. The in vitro activity of antifungal agents to A. calidoustus is variable but generally low among clinical and environmental isolates . It is unknown if combination antifungal therapy provides additional benefit.…”

Section: Discussionmentioning

confidence: 99%

“…A. calidoustus was previously identified as the closely related Aspergillus ustus , but unlike A. ustus , A. calidoustus grows well at or above 37°C and the mycelium color on Czapek yeast extract agar is grayish yellow to grayish brown, compared to the cream or light yellow appearance of A. ustus . A. calidoustus is commonly isolated from food, soil, and air and is more resistant to antifungals, especially triazoles, than other species of Aspergillus (eg, voriconazole minimum inhibitory concentrations [MICs] of 2‐16 μg/mL and posaconazole MICs of ≥1‐16 μg/mL) . Susceptibility to caspofungin and amphotericin B (AmB) is variable (eg, caspofungin minimum effective concentrations of 0.03‐32 μg/mL and AmB MICs of 0.25‐32 μg/mL, respectively) …”

Section: Introductionmentioning

confidence: 99%

Aspergillus calidoustus case series and review of the literature

Seroy

Antiporta

Grim

et al. 2017

Transplant Infectious Dis

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Aspergillus calidoustus, previously classified as Aspergillus ustus, is an emerging pathogen in immunocompromised persons. We describe four recent cases of A. calidoustus and review 37 additional cases of A. calidoustus (n = 8) or A. ustus (n = 29) published through June 2016. Twenty (49%) cases occurred in patients with hematologic malignancy and/or receipt of hematopoietic cell transplantation, and 13 (32%) occurred in solid organ transplant recipients. Antifungal susceptibility was reported in 49% of cases and in 42% treatment failed. Overall mortality was 66% and, where reported, attributable mortality was 30%. A. calidoustus infection is associated with a high mortality rate and frequently displays in vitro antifungal resistance.

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“…Recently, following the application of molecular tools in the context of fungal infections, the classification of the genus Aspergillus has been complicated by the description of new cryptic species within a myriad of complexes each comprising many emerging species, occurring especially in patients having received a transplant. Within these new categories, some species are associated with a high degree of intrinsic resistance to azoles, as for example, A. lentulus that belongs to the complex 'fumigatus' or A. calidoustus within the complex 'ustus' (Van Der Linden et al, 2011;Alastruey-Izquierdo et al, 2014).…”

Section: Global Emergence Of Resistant Aspergillus Strainsmentioning

confidence: 99%

Emerging infections due to filamentous fungi in humans and animals: only the tip of the iceberg?

Debourgogne

Dorin

Machouart

2016

Environ Microbiol Rep

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Over the last few decades, the number of patients susceptible to invasive filamentous fungal infections has steadily increased, especially in populations suffering from hematological diseases. The pathogens responsible for such mycoses are now quite well characterized, such as Aspergillus spp. - the most commonly isolated mold -, Mucorales, Fusarium spp., Scedosporium spp. or melanized fungi. An increase in the incidence of this category of 'emerging' fungi has been recently highlighted, evoking a shift in fungal ecology. Starting from these medical findings, taking a step back and adopt a wider perspective offers possible explanations of this phenomenon on an even larger scale than previously reported. In this review, we illustrate the link between emerging fungi in medicine and changes in ecology or human behaviours, and we encourage integrative approaches to apprehend the adverse effects of progress and develop preventive measures in vast domains, such as agriculture or medicine.

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Antifungal Susceptibility Profile of Cryptic Species of Aspergillus

Cited by 123 publications

References 44 publications

Identification by Molecular Methods and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry and Antifungal Susceptibility Profiles of Clinically Significant Rare Aspergillus Species in a Referral Chest Hospital in Delhi, India

Identification by Molecular Methods and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry and Antifungal Susceptibility Profiles of Clinically Significant Rare Aspergillus Species in a Referral Chest Hospital in Delhi, India

Aspergillus calidoustus case series and review of the literature

Emerging infections due to filamentous fungi in humans and animals: only the tip of the iceberg?

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