Rozaliyani Anna, Abdullah Asriyani, Setianingrum Findra, Sjamsuridzal Wellyzar, Wahyuningsih Retno, Bowolaksono Anom, Fatril Ayu Eka, Adawiyah Robiatul, Tugiran Mulyati, Syam Ridhawati, Wibowo Heri, Kosmidis Chris, Denning David W
Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia.
Indonesia Pulmonary Mycoses Centre, Jakarta 10430, Indonesia.
J Fungi (Basel). 2022 Apr 16;8(4):411. doi: 10.3390/jof8040411.
Cryptic species of 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 are important to support the management of CPA. The aim of this study was to describe the molecular and susceptibility profiles of 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 cryptic species. This is the first report of five cryptic species from clinical isolates in Indonesia: , , , and . 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) ( = 0.003). The species-level characterisation of and its antifungal susceptibility tests demands greater attention to better the management of CPA patients.
在过去几十年中，隐球菌的隐秘菌种迅速增加。慢性肺曲霉病（CPA）是一种使人衰弱的真菌感染，经常影响既往有结核病的患者。不同种类隐球菌的鉴定和抗真菌药敏谱对于支持CPA的管理很重要。本研究的目的是描述从CPA患者中分离出的隐球菌的分子特征和药敏谱。通过对内部转录间隔区（ITS）、部分β-微管蛋白基因和部分钙调蛋白基因进行联合DNA分析来确定分离株的菌种身份。我们发现既往有持续症状的结核病患者中隐球菌隐秘菌种的患病率很高（27%）。29名（49%）患者符合CPA诊断标准，其中24%含有隐球菌隐秘菌种。这是印度尼西亚临床分离株中5种隐球菌隐秘菌种的首次报告：、、、和。值得注意的是，与非CPA组（90%对伊曲康唑敏感）相比，CPA组对伊曲康唑的敏感性降低（66%对伊曲康唑敏感）（P = 0.003）。隐球菌的菌种水平特征及其抗真菌药敏试验需要更多关注，以更好地管理CPA患者。
