The fungi of the genus Aspergillus in lung cavities of tuberculosis patients : a species spectrum and susceptibility to antimycotics

Ref ID: 19488

Author:

A Kulko1*

Author address:

1Moscow Government Health Department, Scientific and Clinical Antituberculosis Center, Moscow, Russia

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Purpose:
To identify species of Aspergillus fungi found in lung cavities of pulmonary tuberculosis (TB)
patients and analyze strains resistance to widely-used antifungal agents.
Methods:
Microscopy and inoculation (onto Sabouraud medium with chloramphenicol) of samples from
lung cavities (resection samples, punctured tissue samples, aspirates); species identification of
isolated strains of mycelial fungi (conventional methods, identification media: Czapek-Dox and
potato dextrose agar); determination of antimycotic susceptibility of isolated strains of the genus
Aspergillus by the broth microdilution method with determination of MIC (μg/ml) (the «Sensititre»
system).
Results:
During 2002-2013 we studied samples from lung cavities (caverns, tuberculomas, cysts,
aspergillomas) from 458 pulmonary TB patients (cavernous TB, fibrocavernous TB, tuberculoma).
Fungi of the genus Aspergillus were found in lung cavities of 49 patients: A. fumigatus – in 29,
A. terreus – in 6, A. niger – in 5, A. flavus – in 4, A. restrictus – in 2, A. versicolor – in 2, A. glaucus
– in one patient. We determined drug resistance as follows: 1) to amphotericin B: for strains
A. fumigatus (n=29) MIC range was 0.5-2 μg/ml, A. terreus (n=6) – 4-8 μg/ml, A. niger (n=5) –
1-2 μg/ml, A. flavus (n=4) – 2-8 μg/ml, A. versicolor (n=2) – 2-4 μg/ml, A. glaucus (n=1) –
0,5 μg/ml; 2) to voriconazole: A. fumigatus (n=29) – 0.06 8722; 0.5 μg/ml, A. terreus (n=6) – 0.12 8722;
0.25 μg/ml, A. niger (n=5) – 0.25 8722; 1 μg/ml, A. flavus (n=4) – 0.12 8722; 0.5 μg/ml, A. versicolor (n=2)
– 0.25 8722; 0.5 μg/ml, A. glaucus (n=1) – 0.25 μg/ml; 3) to itraconazole: A. fumigatus (n=29) – 0.12 –
1 μg/ml, A. terreus (n=6) – 0.12 8722; 0.25 μg/ml, A. niger (n=5) – 0.5 8722; 1 μg/ml, A. flavus (n=4) – 0.06
– 0.5 μg/ml, A. versicolor (n=2) – 0.5 μg/ml, A. glaucus (n=1) – 0.06 μg/ml; 4) to posaconazole:
A. fumigatus (n=29) – 0.03 – 0.25 μg/ml, A. terreus (n=6) – 0.12 8722; 0.25 μg/ml, A. niger (n=5) – 0.12
8722; 0.5 μg/ml, A. flavus (n=4) – 0.06 – 0.5 μg/ml, A. versicolor (n=2) – 0.12 – 0.5 μg/ml, A. glaucus
(n=1) – 0.06 μg/ml.
Conclusion:
The fungus A. fumigatus remains the most common causative agent (59.2% of cases) of secondary
aspergillosis in TB patients with lung cavities (aspergilloma, other forms of aspergillosis). In more
than 10% of cases (12.3%) the fungus A. terreus resistant to amphotericin B was isolated from
patients’ cavities. It was shown that MIC ranges of amphotericin B vary for different Aspergillus
species.

Abstract Number: 16

Conference Year: 2014

Link to conference website: http://www.AAA2014.org

New link: NULL

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