Department of Microbiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India,
Mycopathologia. 2013 Oct;176(3-4):287-94. doi: 10.1007/s11046-013-9690-8. Epub 2013 Aug 15.
Fungal infections of lung have become increasingly common during the last few decades. Aspergillosis and the role of aflatoxins in various chronic lung diseases have not been extensively studied. Bronchoalveolar lavage (BAL) samples and sera from 40 patients of chronic lung diseases were analyzed for galactomannan antigen (GM) and aflatoxin by enzyme-linked immunosorbent assay. Direct microscopy and culture of BAL samples were also done to detect the Aspergillus species. Results revealed that 15 (37.5 %) of the 40 patients had growth of Aspergillus on BAL culture. Out of these culture-positive cases, 13 (86.7 %) patients were positive for galactomannan antigen also. About 62.5 % cases did not show growth of Aspergillus in BAL culture. However, galactomannan antigen could be detected in 20 % of these patients. Overall, 20 % patients were diagnosed as proven invasive fungal disease (IFD), 32.5 % were of probable IFD, 17.5 % of possible IFD. Aspergillus growth was observed in 100 % of proven and 53.8 % of probable IFD cases. Galactomannan antigen was found in 100 % cases of proven and 76.9 % of probable IFD. Ten (25 %) patients were found to be positive for aflatoxins. It was detected in 6 (40 %) of culture-positive cases. About 62.5 % of the cases with proven IFD and 46.1 % of probable IFD had aflatoxin in their samples. Aflatoxin positivity was found to be more in patients with proven IFD than in probable IFD, and higher level of aflatoxins was detected in cases with proven IFD. Significant difference was observed in aflatoxin positivity among food grain workers when compared to other occupations.
在过去的几十年中，肺部真菌感染变得越来越常见。曲霉病和黄曲霉毒素在各种慢性肺部疾病中的作用尚未得到广泛研究。对 40 名慢性肺部疾病患者的支气管肺泡灌洗液（BAL）样本和血清进行了半乳甘露聚糖抗原（GM）和黄曲霉毒素的酶联免疫吸附试验分析。还直接对 BAL 样本进行显微镜检查和培养，以检测曲霉属物种。结果显示，40 名患者中有 15 名（37.5%）BAL 培养物中生长有曲霉。在这些培养阳性病例中，13 名（86.7%）患者也对半乳甘露聚糖抗原呈阳性。大约 62.5%的病例 BAL 培养物中未发现曲霉生长。然而，在这些患者中有 20%可以检测到半乳甘露聚糖抗原。总体而言，20%的患者被诊断为确诊的侵袭性真菌感染（IFD），32.5%为可能的 IFD，17.5%为疑似 IFD。在确诊和可能的 IFD 病例中分别观察到曲霉生长 100%和 53.8%。在确诊和可能的 IFD 病例中均发现半乳甘露聚糖抗原 100%。10 名（25%）患者检测到黄曲霉毒素呈阳性。在 6 名（40%）培养阳性病例中检测到了黄曲霉毒素。在确诊的 IFD 病例中约有 62.5%，在可能的 IFD 病例中约有 46.1%的病例样本中存在黄曲霉毒素。在确诊 IFD 患者中，黄曲霉毒素阳性的比例高于可能的 IFD，并且在确诊 IFD 病例中检测到的黄曲霉毒素水平更高。与其他职业相比，在粮食工人中观察到黄曲霉毒素阳性率差异显著。
