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Virulence capacity of different Aspergillus species from invasive pulmonary aspergillosis
Biao Chen1,2, Guocheng Qian1, Zhiya Yang1
1Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, Shandong, China.
Introduction:
The opportunistic filamentous fungus Aspergillus causes invasive pulmonary aspergillosis (IPA) that often turns into a fatal infection in immunocompromised hosts. However, the virulence capacity of different Aspergillus species and host inflammation induced by different species in IPA are not well understood.
Methods:
In the present study, host inflammation, antimicrobial susceptibilities and virulence were compared among clinical Aspergillus strains isolated from IPA patients.
Results:
A total of 46 strains were isolated from 45 patients with the invasive infection, of which 35 patients were diagnosed as IPA. Aspergillus flavus was the dominant etiological agent appearing in 25 cases (54.3%). We found that the CRP level and leukocyte counts (elevated neutrophilic granulocytes and monocytes, and reduced lymphocytes) were significantly different in IPA patients when compared with healthy individuals (P < 0.05). Antifungal susceptibilities of these Aspergillus isolates from IPA showed that 91%, 31%, 14%, and 14% were resistant to Fluconazole, Micafungin, Amphotericin B and Terbinafine, respectively. The survival rate of larvae infected by A. flavus was lower than larvae infected by A. niger or A. fumigatus (P < 0.05).
Discussion:
Aspergillus flavus was the dominant clinical etiological agent. Given the prevalence of A. flavus in our local clinical settings, we may face greater challenges when treating IPA patients.
Insights
Aspergillus flavus is the most common cause of invasive pulmonary aspergillosis (IPA). This fungus shows high resistance to antifungals and higher virulence, posing treatment challenges.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Immunocompromised Host Research
Background:
- Invasive pulmonary aspergillosis (IPA) is a life-threatening infection in immunocompromised individuals.
- The virulence of different Aspergillus species and their impact on host inflammation remain poorly understood.
Purpose of the Study:
- To compare host inflammation, antimicrobial susceptibilities, and virulence among clinical Aspergillus strains from IPA patients.
- To identify the predominant Aspergillus species causing IPA and assess its clinical implications.
Main Methods:
- Isolation and identification of Aspergillus strains from IPA patients.
- Analysis of host inflammatory markers (CRP, leukocyte counts).
- Antifungal susceptibility testing and comparative virulence assays using larvae.
Main Results:
- Aspergillus flavus was the dominant species (54.3%) in IPA cases.
- IPA patients showed significant differences in CRP levels and leukocyte counts compared to healthy individuals.
- High resistance rates were observed for Fluconazole (91%), Micafungin (31%), Amphotericin B (14%), and Terbinafine (14%).
- A. flavus demonstrated lower survival rates in larvae compared to A. niger and A. fumigatus.
Conclusions:
- Aspergillus flavus is the primary cause of IPA in the study cohort.
- The high prevalence and virulence of A. flavus, coupled with significant antifungal resistance, present considerable challenges for clinical management of IPA.
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