Pathophysiological aspects of<i>Aspergillus</i>colonization in disease

Gago, Sara; Denning, David W.; Bowyer, Paul

doi:10.1093/mmy/myy076

Cited by 81 publications

(91 citation statements)

References 133 publications

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“…Therefore, and because of the high rate of Aspergillus positive cultures concomitant with a positive mycobacterial culture (35,7%), we could recommend being more thorough in considering CPA diagnosis in patients with a positive mycobacterial culture. Systematically adding a mycological culture to respiratory samples positive for Mycobacteria could allow the detection of Aspergillus colonization subsequently at risk for CPA (Gago et al, 2019). A prospective study should be conducted to address this question.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Presence of Aspergillus Species and Mycobacterium Species in the Respiratory Tract of Patients: Underestimated Co-occurrence?

Dellière

Angebault²,

Fihman³

et al. 2020

Front. Microbiol.

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Objectives: Aspergillus and Mycobacterium are opportunistic pathogens that can cause severe pulmonary diseases. To date, the clinical significance of their concomitant isolation and potential interactions in the lung remains poorly understood. The aim of this study was to assess the prevalence of their concomitant isolation from respiratory samples, and to depict the related clinical and microbiological characteristics. Methods: A retrospective monocentric study was conducted from January 2011 to December 2017, including all in-patients from whom positive cultures of Aspergillus and Mycobacterium were obtained on respiratory samples within a 3-month period. Clinical, radiological and laboratory data were analyzed. Patients were categorized by a clinical and microbiological committee as "infected" or "colonized" by both pathogens according to current guidelines. Results: Overall, 140 patients had ≥1 respiratory samples positive for Mycobacterium and concomitantly sent for fungal culture, and 708 were positive for Aspergillus, concomitantly sent for mycobacterial culture. Only 50 had at least one positive culture for both Mycobacterium sp. and Aspergillus sp. Men represented 63% of patients, mean age was 61 years. A third of patients were immunocompromised and 92% had underlying lung diseases. Aspergillus was primarily found as a colonizing agent. Proportion of Mycobacterium Avium Complex (p = 0.02) was higher in patients co-carrying Aspergillus spp. Conclusion: In this first study focusing on co-isolation of Mycobacteria and Aspergillus in patient's respiratory samples, co-infection remains rare. Further studies are warranted in order to precise the exact relationship between these opportunistic pathogens and the clinical impact of co-isolations.

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Section: Discussionmentioning

confidence: 99%

Concomitant Presence of Aspergillus Species and Mycobacterium Species in the Respiratory Tract of Patients: Underestimated Co-occurrence?

Dellière

Angebault²,

Fihman³

et al. 2020

Front. Microbiol.

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“…colonization in COPD was well described over 50 years ago [5,6], but its clinical significance remains unclear. Aspergillus colonization in COPD is frequent, some studies showing a prevalence up to 29% [7,8]. Aspergillus sp.…”

Section: Discussionmentioning

confidence: 99%

A Rare Complication: Development of an Aspergilloma after Endobronchial Coil Placement in a COPD Patient

et al. 2019

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Endobronchial coils are a relatively novel endoscopic lung volume reduction modality that aims to increase functional capacity in chronic obstructive pulmonary disease (COPD) patients. Two major trials have studied the safety and efficacy of this therapy, but long-term safety has not been studied. Adverse events reported are mainly periprocedural pneumothoraces and early bacterial infectious complications. We report the case of a patient with severe emphysema (Global Initiative for Chronic Obstructive Lung Disease stage IV COPD) who developed endobronchial coil-associated aspergillomas 3 years after coil placement.

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“…Nevertheless, a clear understanding of the pathophysiological mechanisms determining allergic and chronic forms of pulmonary aspergillosis such as ABPA has been limited by the lack of reliable murin models of Aspergillus colonization, the prerequisite of fungal infection [ 34 ].…”

Section: Pathogenesis Of Aspergillus Fumigatus mentioning

confidence: 99%

Allergic Bronchopulmonary Aspergillosis in Children with Cystic Fibrosis: An Update on the Newest Diagnostic Tools and Therapeutic Approaches

et al. 2020

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Cystic fibrosis (CF), the most common autosomal-recessive genetic disease in the Caucasian population, is characterized by frequent respiratory infections and progressive lung disease. Fungal species are commonly found in patients with CF, and among them, Aspergillus fumigatus is the most frequently isolated. While bacteria, particularly Pseudomonas aeruginosa, have a well-established negative effect on CF lung disease, the impact of fungal infections remains unclear. In patients with CF, inhalation of Aspergillus conidia can cause allergic bronchopulmonary aspergillosis (ABPA), a Th2-mediated lung disease that can contribute to disease progression. Clinical features, diagnostic criteria and treatment of ABPA are still a matter of debate. Given the consequences of a late ABPA diagnosis or the risk of ABPA overdiagnosis, it is imperative that the diagnostic criteria guidelines are reviewed and standardized. Along with traditional criteria, radiological features are emerging as tools for further classification as well as novel immunological tests. Corticosteroids, itraconazole and voriconazole continue to be the bedrock of ABPA therapy, but other molecules, such as posaconazole, vitamin D, recombinant INF-γ and Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulators, have been showing positive results. However, few studies have been conducted recruiting CF patients, and more research is needed to improve the prevention and the classification of clinical manifestations as well as to personalize treatment. Early recognition and early treatment of fungal infections may be fundamental to prevent progression of CF disease. The aim of this narrative review is to give an update on ABPA in children with CF.

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Pathophysiological aspects ofAspergilluscolonization in disease

Cited by 81 publications

References 133 publications

Concomitant Presence of Aspergillus Species and Mycobacterium Species in the Respiratory Tract of Patients: Underestimated Co-occurrence?

Concomitant Presence of Aspergillus Species and Mycobacterium Species in the Respiratory Tract of Patients: Underestimated Co-occurrence?

A Rare Complication: Development of an Aspergilloma after Endobronchial Coil Placement in a COPD Patient

Allergic Bronchopulmonary Aspergillosis in Children with Cystic Fibrosis: An Update on the Newest Diagnostic Tools and Therapeutic Approaches

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