Rozaliyani Anna, Setianingrum Findra, Isbaniah Fathiyah, Agustin Heidy, Handayani Raden Rara Diah, Syahrir Rosamarlina, Pratiekauri Siti, Adawiyah Robiatul, Setiastuti Hesti, Erhamza Mohammad Nizam, Soemarwoto Retno Ariza S, Medison Irvan, Herman Deddy, Pratama Avissena Dutha, Apridasari Jatu, Jane Jani, Soedarsono Soedarsono, Kusmiati Tutik, Hasanah Mufidatun, Adhyaksanti Diah, Sofvina Winda, Hasyim Ammar A, Kosmidis Chris, Denning David W
Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia.
Pulmonary Mycosis Centre, Jakarta 10430, Indonesia.
J Fungi (Basel). 2025 Apr 22;11(5):329. doi: 10.3390/jof11050329.
A significant complication among post-tuberculosis patients is chronic pulmonary aspergillosis (CPA), with prevalence and outcomes varying by region. This study aimed to explore the epidemiology, clinical characteristics, and microbiological profiles of 219 post-tuberculosis patients with persistent respiratory symptoms and lung cavities in Indonesia.
The patients were divided into CPA ( = 144) and non-CPA ( = 75) groups. This cross-sectional study diagnosed CPA in post-tuberculosis patients using ERS/ESCMID criteria, integrating clinical, radiological, and fungal assessments. Serological tests for -specific IgG were conducted using immunochromatographic (ICT) and ELISA on serum samples. Sputum specimens were used in parallel for fungal culture, and radiological evaluations (e.g., chest X-rays or CT scans) were performed to identify typical CPA features such as cavitation and fibrosis.
Persistent cough was significantly more common in CPA patients (83.3%, = 0.015), highlighting its role as a clinical indicator for CPA. Radiological infiltrates were found in 165 patients (75.3%); critical diagnostic markers of CPA were cavitation and pericavitary fibrosis. -specific IgG testing demonstrated high diagnostic utility, with positivity rates of 69.4% for ICT and 63.2% for ELISA among CPA patients. Among those with infiltrates, a positive culture was not more common ( > 0.05), whereas IgG was more often raised ( = 0.037), as was a positive ICT ( = 0.021). Regional analysis revealed a higher CPA burden in Region 1 (75%) compared to Region 2 (56%, = 0.003), with and predominating in Region 1.
These findings highlight the importance of comprehensive approaches and region-specific CPA management strategies in Indonesia.
肺结核后患者的一个重要并发症是慢性肺曲霉病（CPA），其患病率和结局因地区而异。本研究旨在探讨印度尼西亚219例有持续呼吸道症状和肺空洞的肺结核后患者的流行病学、临床特征和微生物学特征。
将患者分为CPA组（n = 144）和非CPA组（n = 75）。这项横断面研究采用ERS/ESCMID标准对肺结核后患者进行CPA诊断，综合临床、影像学和真菌学评估。使用免疫层析法（ICT）和酶联免疫吸附测定法（ELISA）对血清样本进行针对曲霉特异性IgG的血清学检测。同时使用痰标本进行真菌培养，并进行影像学评估（如胸部X线或CT扫描）以确定CPA的典型特征，如空洞形成和纤维化。
持续性咳嗽在CPA患者中显著更常见（83.3%，P = 0.015），突出了其作为CPA临床指标的作用。165例患者（75.3%）发现有影像学浸润；CPA的关键诊断标志物是空洞形成和空洞周围纤维化。曲霉特异性IgG检测显示出较高的诊断效用，CPA患者中ICT的阳性率为69.4%，ELISA的阳性率为63.2%。在有浸润的患者中，曲霉培养阳性并不更常见（P>0.05），而曲霉IgG升高更常见（P = 0.037），ICT阳性也是如此（P = 0.021）。区域分析显示，与2区（56%，P = 0.003）相比，1区的CPA负担更高（75%），1区以烟曲霉和黄曲霉为主。
这些发现凸显了在印度尼西亚采用综合方法和针对特定区域的CPA管理策略的重要性。
