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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
08:01

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Invasive aspergillosis caused by cryptic species in transplant recipients: A review

Muneyoshi Kimura1,2, Shahid Husain1

  • 1Transplant Infectious Diseases, Ajmera Transplant Program, University Health Network, Toronto, Ontario, M5G 2N2, Canada.

Medical Mycology
|February 11, 2025
PubMed

Insights

Invasive aspergillosis (IA) from cryptic Aspergillus species is a serious threat to transplant recipients. Newer diagnostics and antifungal strategies are crucial for managing these challenging infections.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Transplant Medicine

Background:

  • Invasive aspergillosis (IA) is a common fungal infection in solid organ and hematopoietic stem cell transplant recipients.
  • The clinical and microbiological features of IA caused by cryptic Aspergillus species remain poorly understood in these immunocompromised populations.

Purpose of the Study:

  • To define the clinical and microbiological characteristics of IA caused by cryptic Aspergillus species in transplant recipients.
  • To review diagnostic approaches and antifungal susceptibility patterns for guiding treatment strategies.

Main Methods:

  • Retrospective analysis of reported cases of IA caused by cryptic Aspergillus species.
  • Review of diagnostic modalities including matrix-assisted laser desorption ionization-time of flight mass spectrometry.
  • Analysis of antifungal susceptibility data and treatment outcomes.

Main Results:

  • Aspergillus calidoustus, A. lentulus, A. tubingensis, and A. udagawae were the most common cryptic species identified.
  • Antifungal breakthrough infections occurred in 13 of 24 cases with detailed information.
  • 12-week mortality rates were high, around 43-46% for specific species and overall.

Conclusions:

  • Cryptic Aspergillus species pose a significant challenge in transplant recipients, often presenting with high mortality.
  • Advanced diagnostics like MALDI-TOF MS are vital for accurate species identification.
  • Tailored antifungal regimens, potentially including newer agents, are recommended based on susceptibility profiles.
Keywords:
Aspergillus calidoustus and Aspergillus lentuluscryptic Aspergillus speciesinvasive aspergillosistransplantation

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