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首例烟曲霉气道定植于慢性阻塞性肺疾病患者。

First case of Aspergillus caelatus airway colonization in a Chronic Obstructive Pulmonary Disease patient.

机构信息

Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique universités, EA1155-IICiMed, Nantes, France; Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Institut de Biologie, France.

Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique universités, EA1155-IICiMed, Nantes, France; Departamento de Antibióticos, Universidade Federal de Pernambuco, Recife, Brazil.

出版信息

Int J Infect Dis. 2019 Apr;81:85-90. doi: 10.1016/j.ijid.2019.01.043. Epub 2019 Jan 25.

Abstract

BACKGROUND

During a cross-sectional study on allergic aspergillosis in Chronic Obstructive Pulmonary Disease patients in Bogotá, Colombia, we reported the case of a 65-year-female patient with GOLD 2011 D classification, presenting dyspnea at the time of visit and aspergillus in repeated sputum cultures.

METHODS

The isolate was identified at the section level based on macroscopic and microscopic characteristics and gene sequencing was used for precise molecular identification. Antifungal sensibility was determined by Sensititre YeastOne™ while virulence was assessed using a Galleria mellonella larvae model.

RESULTS

The clinical isolate was first identified as Aspergillus section Flavi and sequencing of β-tubulin and calmodulin genes, in addition to the identification of alfR (aflatoxin regulator) gene, allowed the undoubted identification of the clinical isolate as Aspergillus caelatus. It exhibited virulence in G. mellonella similar to A. flavus and a high in vitro susceptibility against all antifungals except for amphotericin B.

CONCLUSION

This is the first human case of airway colonization attributed to A. caelatus. Resistance pattern justified the interest to discriminate this cryptic species.

摘要

背景

在哥伦比亚波哥大进行的一项关于慢性阻塞性肺疾病患者变应性曲霉菌病的横断面研究中,我们报告了一例 65 岁女性患者的病例,该患者 GOLD 2011 D 分类,就诊时呼吸困难,且反复痰培养中存在曲霉菌。

方法

根据宏观和微观特征在切片水平上对分离株进行鉴定,并使用基因测序进行精确的分子鉴定。通过 Sensititre YeastOne™ 测定抗真菌敏感性,使用大蜡螟幼虫模型评估毒力。

结果

临床分离株最初被鉴定为黄曲霉节,β-微管蛋白和钙调蛋白基因的测序,以及 alfR(黄曲霉毒素调节因子)基因的鉴定,使临床分离株被明确鉴定为土曲霉。它在大蜡螟中表现出类似于黄曲霉的毒力,并且对除两性霉素 B 以外的所有抗真菌药物均具有高度体外敏感性。

结论

这是首例归因于土曲霉的气道定植的人类病例。耐药模式证明了区分这种隐生种的必要性。

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