Tuberculosis and Fungal Co-infection of Fungal Infections, University Hospital Center Zagreb, Croatia, During Past Two Years

M. Jandrlić1 , M. Samarzija2 , V. Rezo Vranješ1 , S. Pleško3 , I. Mareković3 , A. Jandrlic4

Author address: 

1Department Of Clinical And Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia, 2Clinic For Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia, 3Department Of Clinical And Molecular Microbiology, University Hopital Centre Zagreb, Zagreb, Croatia, 4Laboratory Biomedicine, Faculty of Pharmacy, Ljubljana, Slovenia, Zagreb, Slovenia


Objectives: Pulmonary tuberculosis is one of the most important health concerns. Pulmonary fungal infections have clinical and radiological characteristics similar to tuberculosis which may be easily misdiagnosed as tuberculosis. This study aimed to evaluate Mycobacterium tuberculosis (MTB) and other non-tuberculous mycobacteria (NTM) with coinfection of fungal infections in patients, during last 2 years.

Methods: Microbiological and clinical reports of 149 patients with confirmed mycobacteria have been analyzed. Detection and identification of mycobacteria were performed by the standard culture method using the BACTEC MGIT 960 system (BD) and Lowenstein–Jensen medium. Identification of positive Mycobacterium tuberculosis complex (MTBC) was based on positive acid-fast bacilli microscopic smear (Ziehl–Neelsen and fluorochrome), positive niacin accumulation, MALDI-TOF and . Mycobacteria PCR. TB isolates were also tested for their sensitivity toward first-line anti-MTB drugs.

Results: Between April 2017 and April 2019, at 149 patients were detected Mycobacterial infections (MTB 64%, NMT 36%). Mycological tests are not required in 36 24% patients. Mycological tests are required in 113 76% patients. The majority of patients had isolated several types of fungi, 160 episodes. The patients 113 were isolated yeasts, opportunistic and saprophytic molds (54%, 16%, 28%). Frequent Candida were C. albicans, C. dubliniensis, C. parapsilosis and C. glabrata respectively. Frequent Aspergillus were A. niger, A. fumigatus and A. flavus respectively. In addition to Aspergillus, small number of patient had Fusarium, Rhizopus and Pseudallescheria boydii. Saprophytic molds were confirmed in 28% of patients.

Conclusion: Our findings showed the co-infection of fungi agents in patients with tuberculosis that should be considered. Clinical data must be analyzed to be able to distinguish infections, colonization, or part of normal flora. 


abstract No: 


Full conference title: 

9th Trends in Medical Mycology Conference 2019
    • TIMM (2019)