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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
Pulmonary Aspergillosis and Clinical Significance of Aspergillus Isolation from Respiratory Samples |
| Language |
J |
| AuthorList |
Takayoshi Tashiro |
| Affiliation |
Department of Health Promotion Nursing, Nagasaki University Graduate School of Biomedical Sciences |
| Publication |
J.J.C.M.: 19 (2), 67-75, 2009 |
| Received |
April 17, 2009 |
| Accepted |
|
| Abstract |
Recent report have suggested a rising incidence of pulmonary aspergillosis, especially chronic necrotizing pulmonary aspergillosis (CNPA), in pneumology wards, and Aspergillus spp. is being isolated from the respiratory samples at an increasing frequency. CNPA described by Binder et al. is locally invasive forms in patients with mild immunosuppression, however it is considered as chronic pulmonary aspergillosis which needs the antifungal therapy in Japan. Between April 1998 and February 2009, 165 strains of Aspergillus spp. were isolated from the culture of respiratory samples (sputa, endotracheal aspirates, or bronchoalveolar lavage fluids) of 139 patients in the 2nd Department of Internal Medicine of Nagasaki University Hospital. Of 165 isolated Aspergillus spp. A. fumigatus was 67 (40.6%), A. niger was 53 (32.1%), A. versicolor was 20 (12.1%), A. terreus was 10 (6.1%), A. flavus was 9 (5.5%), A. nidulans was 3 (1.8%), A. sydowii was 2 (1.2%), and unidentifiable Aspergillus spp. was 1 (0.6%). From 1998 through 2004, the incidence of A. fumigatus, A. niger and A. terreus was 58.2%, 20.9%, 4.5%, respectively, and from 2005 through 2009, the incidence of those species was 28.6%, 39.8%, 7.1%, respectively. Thus the incidence of non-fumigatus Aspergillus species increased in recent years. Of 139 patients 77 (55.4%) patients had pulmonary aspergillosis: CNPA in 37 (26.6%), aspergilloma in 22 (15.8%), invasive pulmonary aspergillosis (IPA) in 10 (7.2%), and allergic bronchopulmonary aspergillosis (ABPA) in 8 (5.8%), whereas the 62 (44.6%) remaining patients were colonized with Aspergillus spp. The clinical significance of Aspergillus spp. isolation from respiratory tract samples should be determined based on the fungus's pathogenicity and the host's immunological status. |
| Keywords |
Aspergillus fumigatus, non-fumigatus Aspergillus species, pulmonary aspergillosis, chronic necrotizing pulmonary aspergillosis |
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