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Amphotericin B Resistant Aspergillus spp.: Report of Two Cases
Abdurrahman Kaya1, Sibel Yıldız Kaya2, İlker İnanç Balkan2
1Department of Infectious Diseases, İstanbul Training and Research Hospital, İstanbul, Türkiye.
Infectious Diseases & Clinical Microbiology
|January 2, 2025
Summary
Two patients with invasive aspergillosis developed resistance to amphotericin B (AmB), a common antifungal. This resistance led to treatment failure and poor outcomes, highlighting challenges in managing Aspergillus infections.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Medicine
Background:
- Aspergillosis is a serious fungal infection, particularly in immunocompromised individuals.
- Amphotericin B (AmB) has been a primary treatment for invasive aspergillosis for decades.
- Despite its use, AmB treatment success rates remain suboptimal.
Observation:
- Two cases of invasive aspergillosis were identified in patients unresponsive to AmB.
- Fungal isolates from both patients, Aspergillus flavus and Aspergillus fumigatus species complexes, exhibited resistance to AmB.
- Initial diagnostic tests, including serum galactomannan, were negative, complicating early detection.
Findings:
- Invasive pulmonary aspergillosis was suspected based on radiological findings.
- Serum galactomannan levels increased over time, indicating disease progression.
- Both patients ultimately succumbed to their infections in intensive care.
Implications:
- The emergence of AmB-resistant Aspergillus strains poses a significant clinical challenge.
- This highlights the need for alternative antifungal therapies and resistance monitoring.
- Improved diagnostic strategies are crucial for timely intervention in invasive aspergillosis.
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