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

Medical Mycology
|November 12, 2010
PubMed

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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