Journal of The Academy of Clinical Microbiologists

Register      Login

VOLUME 21 , ISSUE 1 ( January-June, 2019 ) > List of Articles

Original Article

‘Clinicomycological correlation and antifungal susceptibility pattern of Aspergillus species’ – A retrospective and prospective study in a tertiary care centre in South India

Bhavna T Jishnu, Ananya Thupakki Sriparna, K Vichitra, Anupma Jyoti Kindo

Keywords : Antifungal susceptibility testing, Aspergillus, azole resistance

Citation Information : Jishnu BT, Sriparna AT, Vichitra K, Kindo AJ. ‘Clinicomycological correlation and antifungal susceptibility pattern of Aspergillus species’ – A retrospective and prospective study in a tertiary care centre in South India. 2019; 21 (1):24-28.

DOI: 10.4103/jacm.jacm_30_18

License: CC BY-NC 4.0

Published Online: 30-06-2019

Copyright Statement:  Copyright © 2019; Wolters Kluwer India Pvt. Ltd.


Abstract

CONTEXT: Aspergillus is present ubiquitously in the environment in the form of spores. Infection due to Aspergilli is uncommon in immunocompetent individuals, unless they possess any abnormalities or have undergone any treatment with corticosteroids in which pulmonary aspergillosis is the most common. In immunocompromised individuals, the infection by this fungus is in a higher extent of risk. AIM: A retrospective study was done and correlated with the antifungal susceptibility pattern of Aspergillus species. MATERIALS AND METHODS: A total of 72 isolates of Aspergillus were collected and confirmed by conventional methods except Aspergillus tetrazonus was identified by DNA sequencing. Antifungal susceptibility testing (AFST) was performed by conventional broth microdilution according to the Clinical Laboratory Standards Institute M38-A2 2008 to all the isolates. RESULTS: In our study, Aspergillus flavus was found to be the predominant followed by Aspergillus niger being the second most to be identified. AFST was performed for all the isolates, where they exhibited minimum inhibitory concentration (MIC) values within the range of 0.0078–2 μg/ml except Aspergillus terreus (4 μg/ml), which exhibited intrinsic resistance to Amphotericin B. CONCLUSION: Aspergillus infection can be treated easily, unless they become invasive. Therefore, antifungal therapy should be started early by determining the MIC values for the isolates, especially for the systemic infections and prevent from mortality.


PDF Share
  1. Latgé JP. Aspergillus fumigatus and aspergillosis. Clin Microbiol Rev 1999;12:310-50.
  2. Xess I, Mohanty S, Jain N, Banerjee U. Prevalence of Aspergillus species in clinical samples isolated in an Indian tertiary care hospital. Indian J Med Sci 2004;58:513-9.
  3. Denning DW. Invasive aspergillosis. Clin Infect Dis 1998;26:781-803.
  4. Beauvais A, Schmidt C, Guadagnini S, Roux P, Perret E, Henry C, et al. An extracellular matrix glues together the aerial-grown hyphae of Aspergillus fumigatus. Cell Microbiol 2007;9:1588-600.
  5. de Hoog GS, Guarro J, Gene J, MJ Figueras. Atlas of clinical fungi, 2nd edn, Centraalbureau voor Schimmelcultures, Utrecht/Universität Rovira I Virgill, Reus, Spain, 2000. p. 1-1126.
  6. Singh R, Urhekar Ad, Singh G. Incidence of Aspergillus infections in patients in a tertiary care Hospital in Navi Mumbai. 2015. 05.10.4172/2165-8056-1000127.
  7. Elefanti A, Mouton JW, Verweij PE, Zerva L, Meletiadis J. Susceptibility breakpoints for amphotericin B and Aspergillus species in an in vitro pharmacokinetic-pharmacodynamic model simulating free-drug concentrations in human serum. Antimicrob Agents Chemother 2014;58:2356-62.
  8. Espinel-Ingroff A, Cuenca-Estrella M, Fothergill A, Fuller J, Ghannoum M, Johnson E, et al. Wild-type MIC distributions and epidemiological cutoff values for amphotericin B and Aspergillus spp. For the CLSI broth microdilution method (M38-A2 document). Antimicrob Agents Chemother 2011;55:5150-4.
  9. Rodriguez-Tudela JL, Alcazar-Fuoli L, Mellado E, Alastruey-Izquierdo A, Monzon A, Cuenca-Estrella M. Epidemiological cutoffs and cross-resistance to azole drugs in Aspergillus fumigatus. Antimicrob Agents Chemother 2008;52:2468-72.
  10. Dannaoui E, Borel E, Monier MF, Piens MA, Picot S, Persat F, et al. Acquired itraconazole resistance in Aspergillus fumigatus. J Antimicrob Chemother 2001;47:333-40.
  11. Denning DW, Marr KA, Lau WM, Facklam DP, Ratanatharathorn V, Becker C, et al. Micafungin (FK463), alone or in combination with other systemic antifungal agents, for the treatment of acute invasive aspergillosis. J Infect 2006;53:337-49.
  12. Pfaller M, Boyken L, Hollis R, Kroeger J, Messer S, Tendolkar S, et al. Use of epidemiological cutoff values to examine 9-year trends in susceptibility of Aspergillus species to the triazoles. J Clin Microbiol 2011;49:586-90.
  13. Patterson TF, Thompson GR 3rd, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the infectious diseases society of America. Clin Infect Dis 2016;63:e1-60.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.