SPECIES IDENTIFICATION AND IN VITRO ANTIFUNGAL SUSCEPTIBILITY TESTING OF ASPERGILLUS ISOLATED FROM VARIOUS CLINICAL SAMPLES
DOI:
https://doi.org/10.22159/ajpcr.2024v17i10.52052Keywords:
Aspergillus, Antifungals, Broth microdilution, Lactophenol cotton blue, Slide cultureAbstract
Objectives: Aspergillus is ubiquitous mold species present in environment in the form of spores. Infection due to Aspergillus is uncommon in immunocompetent individuals unless they possess any abnormality or have undergone any treatment with corticosteroids. In immunocompromised individuals, infection by this fungus is common among people with prolonged neutropenia, transplants, and human immunodeficiency virus infection. The symptoms are diverse, ranging from allergic reactions to invasive aspergillosis and life-threatening complications. The aim of this study is to isolate and identify Aspergillus species obtained from various clinical specimens and perform antifungal susceptibility testing (AFST).
Methods: A total of 200 isolates in which positive direct microscopic findings correlated well with culture growth for Aspergillus were included. Antifungal susceptibility was performed by micro broth dilution technique according to clinical laboratory standard institute M38-A2 guidelines.
Results: Aspergillus flavus was found to be predominant species followed by Aspergillus fumigatus. AFST was performed, where all Aspergillus strains exhibited low minimum inhibitory concentration (MIC) and minimum effective concentration (MEC) values for most of antifungal drugs tested except for one strain of A. flavus, which exhibited high MIC for voriconazole and high MEC for caspofungin.
Conclusion: Polyenes, azoles, and echinocandin resistance are emerging in many parts of the world. Therefore, continued application of AFST combined with morphological characterization for species identification is critical in detecting the emergence of resistance among various Aspergillus species to reduce mortality, morbidity, and overcome treatment failure.
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References
Gautier M, Normand AC, Ranque S. Previously unknown species of Aspergillus. Clin Microbiol Infect. 2016 Aug;22(8):662-9. doi: 10.1016/j.cmi.2016.05.013, PMID: 27263029
Kashyap B, Das S, Kaur IR, Jhamb R, Jain S, Singal A, et al. Fungal profile of clinical specimens from a tertiary care hospital. Asian Pac J Trop Biomed. 2012 Jan 1;2(1):S401-5. doi: 10.1016/S2221-1691(12)60196-8
Misra R, Malik A, Singhal S. Comparison of the activities of amphotericin B, itraconazole, and voriconazole against clinical and environmental isolates of Aspergillus species. Indian J Pathol Microbiol. 2011;54(1):112-6. doi: 10.4103/0377-4929.77352, PMID: 21393890
Sugui JA, Kwon-Chung KJ, Juvvadi PR, Latgé JP, Steinbach WJ. Aspergillus fumigatus and related species. Cold Spring Harb Perspect Med. 2014;5(2):a019786. doi: 10.1101/cshperspect.a019786, PMID: 25377144
Bennett SE. An overview of the genus Aspergillus. In: The Aspergilli. United States: CRC Press; 2007 Dec 7. p. 23-34.
Chander J. Textbook of Medical Mycology. 4th ed. New Delhi: Jaypee Publishers; 2018.
Jishnu BT, Sriparna AT, Vichitra K, Kindo AJ. “Clinicomycological correlation and antifungal susceptibility pattern of Aspergillus species” - A retrospective and prospective study in a tertiary care centre in South India. J Acad Clin Microbiol. 2019 Jun;21(1):24-8.
Xess I, Mohanty S, Jain N, Banerjee U. Prevalence of Aspergillus species in clinical samples isolated in an Indian tertiary care hospital. Indian J Med Sci. 2004 Dec;58(12):513-9. PMID: 15627677
Diba K, Kordbacheh P, Mirhendi SH, Rezaie S, Mahmoudi M. Identification of Aspergillus species using morphological characteristics. Pak J Med Sci. 2007;23(6):867-72.
Clinical and Laboratory Standards Institute. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi; Approved Standard. CLSI document M38-A2. 2nd ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2008.
Marr KA, Patterson TF, Denning DW. Aspergillosis. Pathogenesis, clinical manifestations, and therapy. Infect Dis Clin North Am. 2002 Dec;16(4):875-94. doi: 10.1016/s0891-5520(02)00035-1, PMID: 12512185
Kaur S, Gupta V, Chhina DK, Singh A, Sharma D. Mycological and serological study of invasive Aspergillosis in a tertiary care hospital. J Microbiol Infect Dis. 2018 Mar 1;8(1):8-12. doi: 10.5799/jmid.394584
Singh R, Singh G, Urhekar AD. Incidence of Aspergillus infections in patients in a tertiary care hospital in Navi Mumbai. Fungal Genomics Biol. 2015;5(2):127.
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Copyright (c) 2024 Dr Haripriya Bansal, Dr Loveena Oberoi, Dr Naveen Pandhi, Dr Anuradha Malhotra , Dr Tavishi Oberoi
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