Aspergillus colonization in patients with chronic obstructive pulmonary disease

Abstract

Background and Purpose:Chronic obstructive pulmonary disease (COPD) has been recognized as a risk factor for invasive aspergillosis. Airway colonization by Aspergillus species is a common feature of chronic pulmonary diseases. Nowadays, the incidence of COPD has increased in critically ill patients. The aim of the present study was to isolate and identify Aspergillus colonies in the respiratory tract of COPD patients.Materials and Methods:This study was performed on 50 COPD patients, who were aged above 18 years, and were in intensive care units of three hospitals in Sari, Iran, for at least six days. All the samples obtained from sputum, bronchoalveolar lavage, and tracheal aspirates were cultured for fungi each week. According to the conventional techniques, Aspergillus isolates were initially based on growth and standard morphological characteristics. To confirm the identification of grown Aspergillus, the partial beta-tubulin gene was sequenced using specific primers. Results:A total of 50 patients, who met our inclusion criteria, were enrolled in the study during 2012-14. The results showed that 27 (54%) and 23 (46%) of the participants were male and female, respectively. The majority of the patients developed dyspnea followed by hemoptysis, chest pain, and high fever. Corticosteroids and broad-spectrum antibacterial agents were administered to 75% and 80% of the patients, respectively. Based on the conventional and molecular approaches, A. fumigatus (seven cases; 43.7%), A. flavus (five cases; 31.2%), A. niger (one case; 6.2%), A. terreus (one case; 6.2%), A. orezea (one case; 6.2%), and A. tubingensis (one case; 6.2%) were recovered.Conclusion:Recovery of Aspergillus species from the respiratory tract of COPD patients with pneumonia indicates two possibilities: either colonization or invasive aspergillosis.

Chronic Pulmonary Aspergillosis in Patients with Underlying Respiratory Disorders in Cuba—A Pilot Study

“…As part of the study we tested the association between serology results and a respiratory morbidity (COPD and idiopathic bronchiectasis), yet there was no association between these conditions, which does not mean that patients with these characteristics are “safe groups”. Several studies report that airway colonization by Aspergillus species could be a threat for the development of aspergillosis after contracting COPD, where there is poor lung function and the use of corticosteroids is usual [14,15,16,17]. Cuban health stats from 2017 report that chronic diseases of the lower airways rank sixth place in frequency among mortality causes in the country.…”

<p>Invasive Aspergillosis After Non-Fatal Drowning</p>

“…Airway colonization by Aspergillus species is common among COPD patients in intensive care units. 8 Although there was no obvious history of COPD in our patient, he had a long history of smoking and, therefore, the impaired ciliary activity might have affected the defense mechanisms of the airways and allowed for fungal invasion. Moreover, as he had hypothermia his first presentation and his baseline white cell count was low, he may have had an impaired immune response.…”

High burden of Aspergillus fumigatus infection among chronic respiratory diseases

“…Although, past reports showed that AF were cultured in 43.7% of COPD patients and 68.7% of non-neutropenic and non-transplant patients, but up to date there were no past reports showing differences of contamination rates between AF and non-AF pathogens. 35 , 36 …”