Invasive aspergillosis in patients with different underlying diseases from Iran

MT Hedayati1, M Taghizadeh-Armaki 2, S Hedayati3, S Mahdavi Omran2, H Zarrinfar 4, S Saber5, SM Seyedmousavi6

Author address: 

1Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran 2Department of Medical Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran 3Student Research Committee, School of pharmacy, Mazandaran University of Medical Science, Sari, Iran 4Department of Medical Mycology and Parasitology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 5School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 6Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious , Maryland, United States of America

Abstract: 

Purpose: The incidence of invasive aspergillosis (IA) has increased significantly over the past decades, and it is associated with a high morbidity and mortality in immunocompromised hosts and hospitalized patients with severe underlying diseases. In this present study, we assessed the incidence of IA in patients with different underlying diseases by culture and non-culture based diagnostic methods from Iran.

Methods: In a prospective study between 2009 and 2015, 116 patients with different underlying diseases who were suspected to IA were enrolled in the study. Patients were classified as having proven, probable or possible IA, according to the Invasive Fungal Infections Group of the European Organization for the Research and Treatment of Cancer/ Mycoses Study Group (EORTC/ MSG) case definitions and the clinical algorithm suggested by Blot et al. Detection of GM in collected bronchopulmonary lavage (BAL) samples as well as culture onto the Sabouraud glucose agar at 30 °C for 10 days were included as a microbiological criteria.

Results: The mean age of the 116 studied patients was 46 ± 15.4 ranging from 12 to 78 years. Seventy-three (62.9%) patients were male. Out of 116 suspected patients to IA, 38 cases (32.8%) showed IA. According to EORTC/MSG criteria, two cases were classified as proven IA and 16 cases as probable IA and based on the clinical algorithm suggested by Blot et al, 17 cases were identified as putative IA. Three possible cases with a host factor and radiological features were reported. Out of 116 BAL samples, 38 cases (32.7%) had positive culture for Aspergillus. Using PCR-sequencing targeting beta-tubulin region of rDNA, A. flavus (28, 80%) and A. fumigatus (7, 20%) were identified. Out of 35 patients with IA, 10 (28.6%) had underlying hematologic malignancy. According to BAL GM index ≥ 0.5, of 116 patients, 33 (28.4%) with IA and 5 (4.3%) cases without IA had positive results.

Conclusion: The results of the present study have emphasized the importance of IA as a life- threatening infections in patients with severe underlying diseases. Our data have also revealed that GM detection in BAL samples play a significant role to IA diagnosis.

2018

Full conference title: 

The 8th Advances Against Aspergillus, Lisbon Conference Center, Lisbon, Portugal
    • AAA 8th (2018)