Predominance of non-fumigatus Aspergillus species among patients suspected to pulmonary aspergillosis in a tropical and subtropical region of the Middle East

Zanganeh, Elnaz; Zarrinfar, Hossein; Rezaeetalab, Fariba; Fata, Abdolmajid; Tohidi, Mohammad; Najafzadeh, Mohammad Javad; Alizadeh, Majid; Seyedmousavi, Seyedmojtaba

doi:10.1016/j.micpath.2018.01.047

Cited by 34 publications

(21 citation statements)

References 39 publications

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“…Aspergillus fumigatus has been reported as the most prevalent species causing IA in different parts of the world, including the United States, Europe and Brazil (Balajee et al, 2009; Alastruey-Izquierdo et al, 2013; Negri et al, 2014). In this study, A. flavus was the most prevalent species (27%), which is consistent with reports from India (47%) (Xess et al, 2004), Iran (75%) (Zanganeh et al, 2018), and Tunisia (79%) (Hadrich et al, 2010). The predominance of A. flavus in these parts of the world is attributed to arid and semi-arid climates (Kameswaran et al, 1992; Hedayati et al, 2007).…”

Section: Discussionsupporting

confidence: 92%

The Emergence of Rare Clinical Aspergillus Species in Qatar: Molecular Characterization and Antifungal Susceptibility Profiles

et al. 2019

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Aspergillus are ubiquitous mold species that infect immunocompetent and immunocompromised patients. The symptoms are diverse and range from allergic reactions, bronchopulmonary infection, and bronchitis, to invasive aspergillosis. The aim of this study was to characterize 70 Aspergillus isolates recovered from clinical specimens of patients with various clinical conditions presented at Hamad general hospital in Doha, Qatar, by using molecular methods and to determine their in vitro antifungal susceptibility patterns using the Clinical and Laboratory Standards Institute (CLSI) M38-A2 reference method. Fourteen Aspergillus species were identified by sequencing β-tubulin and calmodulin genes, including 10 rare and cryptic species not commonly recovered from human clinical specimens. Aspergillus welwitschiae is reported in this study for the first time in patients with fungal rhinosinusitis ( n = 6) and one patient with a lower respiratory infection. Moreover, Aspergillus pseudonomius is reported in a patient with fungal rhinosinusitis which is considered as the first report ever from clinical specimens. In addition, Aspergillus sublatus is reported for the first time in a patient with cystic fibrosis. In general, our Aspergillus strains exhibited low MIC values for most of the antifungal drugs tested. One strain of Aspergillus fumigatus showed high MECs for echinocandins and low MICs for the rest of the drugs tested. Another strain of A. fumigatus exhibited high MIC for itraconazole and categorized as non-wild type. These findings require further analysis of their molecular basis of resistance. In conclusion, reliable identification of Aspergillus species is achieved by using molecular sequencing, especially for the emerging rare and cryptic species. They are mostly indistinguishable by conventional methods and might exhibit variable antifungal susceptibility profiles. Moreover, investigation of the antifungal susceptibility patterns is necessary for improved antifungal therapy against aspergillosis.

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Section: Discussionsupporting

confidence: 92%

The Emergence of Rare Clinical Aspergillus Species in Qatar: Molecular Characterization and Antifungal Susceptibility Profiles

et al. 2019

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“…Unlike Europe and North America, non- fumigatus Aspergillus species are more common in the Middle East and South Asia. [ 22 ] Interestingly, this geographic variation in Aspergillus species distribution is also notable in the previous CPAP report from Pakistan, compared with reports from other parts of the world ( Table 1 ). [ 5 , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [16] , [17] , [18] , [19] , [20] ].…”

Section: Discussionsupporting

confidence: 53%

Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature

Abdalla

Almaslamani

Hashim

et al. 2020

IDCases

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Coronavirus Disease 2019 (COVID-19)-associated pulmonary aspergillosis is an emerging entity. We report two fatal cases of putative COVID-19-associated pulmonary aspergillosis. Both cases were diagnosed on the basis of respiratory tract cultures yielding Aspergillus species and otherwise unexplained clinical and radiological deterioration. Existing published literature on COVID-19-associated pulmonary aspergillosis indicate poor outcomes and high mortality. CAPA should be considered in patients with critical COVID-19 who have unexplained progressive respiratory failure despite optimized supportive care. Diagnostic work-up should be initiated as early as possible and should ideally include fungal cultures, galactomannan detection and Aspergillus PCR on tracheal aspirates or broncho-alveolar lavage fluid. Empiric systemic antifungal therapy may be justified in selected cases, pending diagnostic work up results. Large, multi-center studies are required to further understand the pathogenesis of invasive aspergillosis in COVID-19, and the optimal diagnostic and treatment strategies.

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“…Regarding species distribution, A. fumigatus predominated in IFIs of hospital discharges in both Lebanon and Saudi Arabia (60%) [39] and was responsible for 53% of IA in Bahrain [78]. A. flavus was predominant in 75% of bronchoalveolar lavage (BAL) samples in Iran [83] and in 37.5% of sputum samples and 79.2% among clinical samples of hematology patients in Tunisia [81,84].…”

Section: Invasive Aspergillosismentioning

confidence: 99%

Update on invasive fungal infections in the Middle Eastern and North African region

et al. 2020

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In the recent years, the epidemiology of invasive fungal infections (IFIs) has changed worldwide. This is remarkably noticed with the significant increase in high-risk populations. Although surveillance of such infections is essential, data in the Middle Eastern and North African (MENA) region remain scarce. In this paper, we reviewed the existing data on the epidemiology of different IFIs in the MENA region. Epidemiological surveillance is crucial to guide optimal healthcare practices. This study can help to guide appropriate interventions and to implement antimicrobial stewardship and infection prevention and control programs in countries.

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Predominance of non-fumigatus Aspergillus species among patients suspected to pulmonary aspergillosis in a tropical and subtropical region of the Middle East

Cited by 34 publications

References 39 publications

The Emergence of Rare Clinical Aspergillus Species in Qatar: Molecular Characterization and Antifungal Susceptibility Profiles

The Emergence of Rare Clinical Aspergillus Species in Qatar: Molecular Characterization and Antifungal Susceptibility Profiles

Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature

Update on invasive fungal infections in the Middle Eastern and North African region

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