Department of Microbiology, Hospital Clinic, Barcelona,Spain; ISGlobal, Barcelona, Institute for Global health, Universitat de Barcelona, Barcelona,Spain.
Department of Microbiology, Hospital Clinic, Barcelona,Spain.
Rev Iberoam Micol. 2022 Apr-Jun;39(2):44-49. doi: 10.1016/j.riam.2022.04.002. Epub 2022 Jun 23.
The cryptic Aspegillus species are rare, these microorganisms are usually more resistant to common antifungal therapies. Therefore, a correct identification is important when evaluating the impact of such species in aspergillosis.
We aimed to describe the frequency, clinical and microbiological characteristics, and the outcomes of those cases of aspergillosis caused by cryptic species in a tertiary hospital.
We retrospectively identified all microbiologically documented cases of aspergillosis between January 2013 and December 2018. Definitive species identification of clinically significant isolates was achieved via sequencing methods. The polymerase chain reaction (PCR) products were sequenced, and the results obtained were compared to sequences deposited in GenBank. Antifungal susceptibility testing was performed using the Sensititre® YeastOne® panel.
A total of 679 Aspergillus isolates were recovered from 489 patients, of which 109 were clinically relevant. Ten (9.2%) isolates were identified as cryptic species: Aspergillus arcoverdensis (2), Aspergillus lentulus (2), Aspergillus ellipticus (2), Aspergillus alliaceus (1), Aspergillus nomius (1), Aspergillus tubingensis (1) and Aspergillus montevidensis (1). Most patients already suffered some type of immunosuppression. Half of these patients had required intensive care before the infection showed up, and most of them had a pulmonary infection. Mortality at the 100-day follow-up was 40%. Antifungal susceptibility testing was performed on three of the isolates (A. arcoverdensis, A. tubingensis and A. nomius), which showed high minimum inhibitory concentrations (MIC) for azoles and amphotericin B.
The frequency of cryptic species in our centre was 9.2%. Most patients had some degree of immunosuppression, and the mortality rate was 40%.
隐球菌种系罕见，这些微生物通常对常见抗真菌治疗更具耐药性。因此，在评估此类物种在曲霉病中的影响时，正确鉴定非常重要。
我们旨在描述三级医院中由隐球菌种引起的曲霉病的频率、临床和微生物学特征以及结局。
我们回顾性地确定了 2013 年 1 月至 2018 年 12 月间所有经微生物学证实的曲霉病病例。通过测序方法对临床有意义的分离株进行明确的种系鉴定。聚合酶链反应（PCR）产物测序，并将结果与 GenBank 中保存的序列进行比较。使用 Sensititre® YeastOne®板进行抗真菌药敏试验。
从 489 例患者中分离出 679 株烟曲霉，其中 109 株与临床相关。10 株（9.2%）鉴定为隐球菌种：阿萨希毛霉（2）、勒氏曲霉（2）、椭圆曲霉（2）、大蒜曲霉（1）、拟诺卡氏菌（1）、管曲霉（1）和蒙特维的亚曲霉（1）。大多数患者已经患有某种类型的免疫抑制。这些患者中有一半在感染出现前曾需要重症监护，大多数患者有肺部感染。100 天随访时的死亡率为 40%。对 3 株分离株（阿萨希毛霉、管曲霉和拟诺卡氏菌）进行了抗真菌药敏试验，结果显示对唑类和两性霉素 B 的最低抑菌浓度（MIC）较高。
我们中心隐球菌种的频率为 9.2%。大多数患者有一定程度的免疫抑制，死亡率为 40%。
