Adeyinka A Davies, Bram Spruijtenburg, Eelco F J Meijer, Iriagbonse I Osaigbovo, Oluwaseyi Balogun, Abiola Adekoya, Titilola Gbaja-Biamila, Jacques F Meis, Rita Oladele
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引用次数: 0
Abstract
Background: Triazole resistance in Aspergillus spp. has therapeutic implications for managing chronic pulmonary aspergillosis (CPA) worldwide. However, antifungal susceptibility testing (AFST) is not routinely performed in Nigeria, a country with a high CPA burden.
Objective: This study aimed to confirm the identity of Aspergillus spp. isolated from patients with CPA using molecular methods, determine their antifungal susceptibility profile, and ascertain phylogenetic relatedness.
Methods: This study examined 47 Aspergillus isolates from sputum samples obtained in a prospective longitudinal study of CPA prevalence among 141 consenting symptomatic tuberculosis patients in Lagos, Nigeria, between June 2021 and May 2022. The preliminary phenotypically identified Aspergillus spp. were further identified by amplifying the calmodulin gene and performing AFST against seven antifungal agents using the Clinical Laboratory Standard Institute (CLSI) micro-dilution method, as well as determining their phylogenetic relatedness.
Results: The 51 patients who met the diagnostic criteria for CPA included 30 (59.0%) male and 21 (41.0%) female patients (age range: 17-68 years). Thirty-six (71.0%) had positive Aspergillus cultures. An isolate, initially identified phenotypically as A. fumigatus, was reidentified as A. pseudonomiae. Phylogenetic analysis on A. fumigatus and A. flavus isolates suggested the absence of clonal transmission. All isolates were susceptible to the tested antifungals.
Conclusion: Clinical Aspergillus isolates from azole-naïve patients with CPA did not demonstrate triazole resistance. Nonetheless, AFST is required for patients on long-term azole therapy and systematic surveillance of clinical and environmental isolates is recommended to detect the emergence of azole-resistant phenotypes.
What this study adds: This study underscores the importance of routine surveillance for antifungal resistance to detect the occurrence of resistance strains early in clinical settings, as this has therapeutic implications for patients harbouring resistant phenotypes.
期刊介绍：
The African Journal of Laboratory Medicine, the official journal of ASLM, focuses on the role of the laboratory and its professionals in the clinical and public healthcare sectors,and is specifically based on an African frame of reference. Emphasis is on all aspects that promote and contribute to the laboratory medicine practices of Africa. This includes, amongst others: laboratories, biomedical scientists and clinicians, medical community, public health officials and policy makers, laboratory systems and policies (translation of laboratory knowledge, practices and technologies in clinical care), interfaces of laboratory with medical science, laboratory-based epidemiology, laboratory investigations, evidence-based effectiveness in real world (actual) settings.
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