Clinico-Microbiological Profile of Chronic Pulmonary Aspergillosis from a Tertiary Care Centre in Southern India

Chawla, Kiran; Kosaraju, Kranthi; Rayasam, Sridevi; Mukhopadhyay, Chiranjay

doi:10.7860/jcdr/2013/6314.3740

Cited by 9 publications

(13 citation statements)

References 16 publications

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“…In our study, most of the patients were middle-age persons and there was a minor difference in the presentation of CPA in gender, with a predominance in men. These results are similar to other investigations [9,10,11] and according to experts the disease is more frequent in middle-aged men [12]. Aging affects the anatomy of the lungs, degenerating lung parenchyma and the elastic fibers around the alveolar duct.…”

Section: Discussionsupporting

confidence: 91%

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

Rodríguez

Galán

Andreu

et al. 2019

JoF

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Chronic pulmonary aspergillosis (CPA) is a fungal infection with high mortality and morbidity rates. This disease is caused by several Aspergillus species and affects patients with an underlying respiratory condition. This pilot study aims to recognize CPA among patients with different respiratory diseases. Twenty-one out of 47 patients were classified as CPA based on the examination of clinical signs and symptoms, radiological findings, mycological culture of respiratory samples and analysis of Aspergillus IgG antibodies. There was a close association between high levels of Aspergillus IgG antibodies and the presence of cavities. Although Aspergillus flavus was the predominant species among clinical isolates, the number of isolates was small to reach conclusions on the prevalence of this species as main cause of CPA in Cuba. From the eleven evaluable patients for the treatment with itraconazole (Lozartil®), nine improved their health status while two did not show any recovery. This drug is included in the therapy schemes for aspergillosis in Cuba.

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Section: Discussionsupporting

confidence: 91%

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

Rodríguez

Galán

Andreu

et al. 2019

JoF

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“…Globally, Aspergillus fumigatus is the most frequent cause of invasive aspergillosis, causing over 90% of such infections [ 8 ], followed by Aspergillus flavus , Aspergillus niger and Aspergillus terreus . Distribution varies by geographic location, for example, A. flavus is isolated at least as frequently as A. fumigatus in subtropical and tropical regions [ 9 , 10 ].…”

Section: Epidemiology Of Azole Resistancementioning

confidence: 99%

Responding to the Emergence of Antifungal Drug Resistance: Perspectives from the Bench and the Bedside

et al. 2018

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The incidence of serious fungal infections is increasing rapidly, and yet the rate of new drugs becoming available to treat them is slow. The limited therapeutic armamentarium is a challenge for clinicians, because the available drugs are often toxic, expensive, difficult to administer, ineffective or a combination of all four. Given this setting, the emergence of resistance is especially concerning, and a review of the topic is timely. Here we discuss antifungal drug resistance in Candida spp. and Aspergillus spp. with reference to the most commonly used first-line antifungal agents – azoles and echinocandins. We review the resistance mechanisms of the leading pathogens, how resistance can be identified in the diagnostic lab and the clinical implications of resistance once detected.

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“…The incidence and prevalence of PA are on the rise due to an increase in the number of immunocompromised patients, but the disease is largely unexplored in developing countries. Because of this, it has emerged as a worldwide healthcare problem [134].…”

Section: Introductionmentioning

confidence: 99%

Phenotypic profile of pulmonary aspergillosis and associated cellular immunity among people living with human immunodeficiency virus in Maiduguri, Nigeria

et al. 2019

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Objective: Aspergillus causes many forms of pulmonary infectious diseases ranging from colonization (noninvasive) to invasive aspergillosis. This largely depends on the underlying host's lung health and immune status. Pulmonary aspergillosis (PA), especially the invasive form, occurs as opportunistic to human immunodeficiency virus (HIV) as a result of cluster of differentiation (CD)4+ lymphopenia. The majority of patients with comorbid HIV and aspergillosis go undiagnosed. This study aimed to isolate, identify the etiologies, and determine the prevalence of PA among HIV-infected persons with a productive cough (at least <2 weeks) at the HIV Clinics of the University of Maiduguri Teaching Hospital, Nigeria. Materials and Methods: After ethical approval, three consecutive early morning sputum samples were collected from patients with negative tuberculosis results. The samples were individually inoculated onto Sabouraud dextrose agar supplemented with chloramphenicol and cycloheximide in duplicate for 7 days at 37°C and 25°C, respectively. The fungal isolates were examined morphologically and microscopically and identified using the standard biochemical reagents. CD4+ cell counts were performed using flow cytometry. Self-administered questionnaires were used to assess the patients data. All patients were antiretroviral naïve. Results: The prevalence of PA was 12.7% in these 150 patients. Of the 19 fungal culture-positive individuals, Aspergillus fumigatus accounted for the highest proportion of the isolates (8, 42.1%) followed by Aspergillus niger (5, 26.3%), Aspergillus flavus (4, 21.1%), and Aspergillus terreus (2, 10.5%). Based on the assessment of functionality of cellular immunity, HIV participants who were negative for PA (131/150) had significantly higher mean ± standard deviation CD4 T-cell counts (245.65 ± 178.32 cells/mL) than those with aspergillosis (126.13 ± 105.27 cells/mL) ( P = 0.0051). PA was relatively highest among patients with CD4+ cell counts <200 cells/mL (12. 34.3%) followed by those with CD4+ cell counts between 200 and 350 cells/mL (5, 9.6%) and least among those with CD4+ cell counts >350 cells/mL (2, 3.2%). The Chi-square test showed a significant association between the prevalence of PA and the CD4+ cell count, age, and gender ( P < 0.05) but not with occupation or education level ( P > 0.05). Conclusion: The findings from this study indicate that Aspergillus spp. is a significant etiology of acute productive cough in people living with HIV and this is related to the CD4+ cell count of coinfected persons.

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Clinico-Microbiological Profile of Chronic Pulmonary Aspergillosis from a Tertiary Care Centre in Southern India

Abstract: Background: Pulmonary aspergillosis is commonly seen in immunocompromised individuals. A significant rise has been seen in these cases in the past decade, owing to growing number of patients with impaired immune status.

Cited by 9 publications

References 16 publications

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

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

Responding to the Emergence of Antifungal Drug Resistance: Perspectives from the Bench and the Bedside

Phenotypic profile of pulmonary aspergillosis and associated cellular immunity among people living with human immunodeficiency virus in Maiduguri, Nigeria

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