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Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Unusual Aspergillus species in patients with cystic fibrosis
Françoise Symoens1, Gerhard Haase, Marc Pihet
1Scientific Institute of Public Health, Brussels, Belgium. Francoise.Symoens@wiv-isp.be
Abstract:
Poorly sporulating Aspergillus isolates from patients with cystic fibrosis (CF) are generally identified in routine procedures as Aspergillus spp. In this study, we identified and characterized 11 isolates belonging to two unusual Aspergillus species of the section Fumigati (A. lentulus and Neosartorya pseudofischeri) recovered from four different patients. Aspergillus lentulus was found occasionally during a 10-year follow-up study of one CF patient colonized by A. fumigatus. Neosartorya pseudofischeri was isolated from three patients followed in different European hospitals. This species was recovered from two sputum samples of one patient, and from four successive samples of the two other patients, suggesting that it may be responsible for chronic colonization. Both species were isolated together with A. fumigatus. Isolates from both species did not grow at 50°C, and DNA sequence analysis, together with further morphological observations permitted identification at the species level. Growth at different temperatures and antifungal susceptibility were also investigated. All the isolates of N. pseudofischeri exhibited a very low susceptibility to voriconazole (VRZ) whereas a very low susceptibility to VRZ and amphotericin B was seen with the A. lentulus isolates.
Insights
Two rare Aspergillus species, Aspergillus lentulus and Neosartorya pseudofischeri, were identified in cystic fibrosis patients. These fungi show reduced susceptibility to common antifungal treatments, posing potential challenges in managing infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Routine identification of Aspergillus species in cystic fibrosis (CF) patients often misclassifies unusual or poorly sporulating isolates.
- Accurate identification is crucial for effective antifungal treatment and patient management.
Observation:
- Eleven isolates of Aspergillus lentulus and Neosartorya pseudofischeri were recovered from four CF patients.
- These species, belonging to the Aspergillus section Fumigati, were often co-isolated with Aspergillus fumigatus.
- A. lentulus was observed during a decade-long study of one CF patient, while N. pseudofischeri was found in multiple patients across different hospitals.
Findings:
- DNA sequencing and morphological analysis confirmed the species identification, distinguishing them from Aspergillus spp.
- Neither A. lentulus nor N. pseudofischeri grew at 50°C.
- All N. pseudofischeri isolates displayed very low susceptibility to voriconazole (VRZ).
- A. lentulus isolates showed very low susceptibility to both VRZ and amphotericin B.
Implications:
- The identification of A. lentulus and N. pseudofischeri highlights the need for advanced diagnostic methods in CF patient care.
- The observed antifungal resistance patterns suggest potential treatment limitations and the need for alternative therapeutic strategies.
- These findings underscore the importance of species-level identification for understanding fungal colonization and infection dynamics in immunocompromised individuals.
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