Unravelling the Molecular Identification and Antifungal Susceptibility Profiles of Aspergillus spp. Isolated from Chronic Pulmonary Aspergillosis Patients in Jakarta, Indonesia: The Emergence of Cryptic Species

Anna Rozaliyani, Asriyani Abdullah, Findra Setianingrum, Wellyzar Sjamsuridzal, Retno Wahyuningsih, Anom Bowolaksono, Ayu Eka Fatril, Robiatul Adawiyah, Mulyati Tugiran, Ridhawati Syam, Heri Wibowo, Chris Kosmidis, David W. Denning

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Abstract

Cryptic species of Aspergillus have rapidly increased in the last few decades. Chronic pulmonary aspergillosis (CPA) is a debilitating fungal infection frequently affecting patients with previous TB. The identification and antifungal susceptibility profiles of different species of Aspergillus are important to support the management of CPA. The aim of this study was to describe the molecular and susceptibility profiles of Aspergillus isolated from CPA patients. The species identity of isolates was determined by combined DNA analyses of internal transcribed space (ITS), partial β-tubulin genes, and part of the calmodulin gene. We revealed a high (27%) prevalence of cryptic species among previous tuberculosis patients with persistent symptoms. Twenty-nine (49%) patients met the criteria for diagnosis of CPA with 24% containing Aspergillus cryptic species. This is the first report of five cryptic Aspergillus species from clinical isolates in Indonesia: A. aculea tus, A. neoniger, A. brunneoviolacues, A. welwitschiae, and A. tubingensis. Significantly, there was decreased sensitivity against itraconazole in the CPA group (66% susceptible to itraconazole) compared to the non-CPA group (90% susceptible to itraconazole) (p = 0.003). The species-level characterisation of Aspergillus and its antifungal susceptibility tests demands greater attention to better the management of CPA patients.

Original languageEnglish
Article number411
JournalJournal of Fungi
Volume8
Issue number4
DOIs
Publication statusPublished - Apr 2022

Keywords

  • Antifungal susceptibility
  • Aspergillus
  • Chronic pulmonary aspergillosis
  • Cryptic
  • Tuberculosis

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