Dataset Information

Emerging Aspergillus lentulus infections in Taiwan: clinical and environmental surveillance.

ABSTRACT:

Objectives

This study aimed to investigate the prevalence and characteristics of Aspergillus lentulus clinical and environmental isolates in Taiwan.

Methods

Aspergillus isolates obtained from patients at three hospitals and from 530 soil samples across Taiwan were screened. A. lentulus, confirmed by calmodulin sequencing, was subjected to antifungal susceptibility testing and cyp51A analyses. Soil samples yielding A. lentulus were analysed for residues of 25 azole fungicides.

Results

Nine A. lentulus isolates were identified, which included seven (1.2%, 7/601) isolates from three antifungal-naïve patients out of 601 Aspergillus section Fumigati clinical isolates and two (0.3%, 2/659) isolates out of 659 Aspergillus soil isolates. All isolates developed white colonies and failed to grow at 48°C. They were susceptible to anidulafungin but showed reduced susceptibility to amphotericin B (AmB), voriconazole and azole fungicides. One heart transplant recipient with proven invasive pulmonary aspergillosis (IPA) initially showed suboptimal response to voriconazole monotherapy but was cured with a combination of voriconazole-caspofungin, liposomal AmB (LAmB)-caspofungin, along with surgery, followed by voriconazole maintenance therapy. Among two critically ill patients with probable IPA, one survived with micafungin, while the other died of aspergillosis despite sequential isavuconazole and LAmB monotherapy. Clinical and environmental isolates sharing identical Cyp51A sequence are identified, matching the Cyp51A sequence of A. lentulus NIID0096. Flusilazole (0.0009 mg/kg) was detected in one soil sample.

Conclusions

This study raises concerns about health threat posed by human pathogenic A. lentulus originating from natural environments and underscores the need for increased clinical and laboratory vigilance regarding A. lentulus infections.

SUBMITTER: Chen PY

PROVIDER: S-EPMC11358634 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

Emerging <i>Aspergillus lentulus</i> infections in Taiwan: clinical and environmental surveillance.

Chen Pao-Yu PY Chao Chien-Ming CM Luo Chwan-Yau CY Tseng Yau-Lin YL Chen Po-Lin PL Roan Jun-Neng JN Liu Wei-Lun WL Chu Chien C Wu Chi-Jung CJ Wang Hsuan-Chen HC Hsieh Ming-I MI Choi Pui-Ching PC Chen Yee-Chun YC

JAC-antimicrobial resistance 20240829 4

<h4>Objectives</h4>This study aimed to investigate the prevalence and characteristics of <i>Aspergillus lentulus</i> clinical and environmental isolates in Taiwan.<h4>Methods</h4><i>Aspergillus</i> isolates obtained from patients at three hospitals and from 530 soil samples across Taiwan were screened. <i>A. lentulus</i>, confirmed by calmodulin sequencing, was subjected to antifungal susceptibility testing and <i>cyp51A</i> analyses. Soil samples yielding <i>A. lentulus</i> were analysed for re ...[more]

PMID: 39211803

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Project description:BackgroundIn recent years, the number of invasive aspergillus infection cases caused by Aspergillus lentulus (A. lentulus) has gradually increased and this fungus is usually difficult to distinguish from Aspergillus fumigatus in morphology. All of these presents a great challenge to the treatment of invasive fungal infections caused by A. lentulus. The present study aims to discuss the antifungal resistance, virulence and inflammatory factors' changes after the infection of larvae of A. lentulus separated from patients with chronic obstructive pulmonary disease (COPD) to reflect the host immune response.MethodsA. lentulus isolated from COPD patients was identified by morphology and molecular biology, and its drug sensitivity was determined in vitro. Then the virulence factors and inflammatory response related factors of A. lentulus were determined by the model of A. lentulus infecting larvae. These were divided into three groups: A. lentulus standard strain, A. lentulus strain isolated from patients; PBS control. The infection model was formed by injecting the suspension of A. lentulus at a concentration of 1×106 CFU into larvae, in order to determine the (1,3)-β-D-glucan and galactomannan levels, and determine the caspase-1 and TNF-α concentration in Galleria mellonella larvae by RT-PCR.ResultsThe results revealed that A. lentulus had good sensitivity to itraconazole, voriconazole and micafungin, while (1,3)-β-D-glucan was negative in the two groups. The level of galactomannan in the two groups was higher than that in the control group, and the difference was statistically significant (P<0.05). However, there was no statistical difference between the standard strain group and patient strain group (P>0.05). After the infection of larvae, caspase-1 and TNF-α in the Galleria mellonella larvae increased in the two groups, and these elevated levels were statistically significant in both groups (P<0.05). However, there was no significant difference between the two groups (P>0.05).ConclusionsThere is no significant difference in virulence factor and host inflammatory response between A. lentulus isolated from COPD patients and standard strains. Galactomannan has more advantages in the early detection of A. lentulus invasive infection. Furthermore, the caspase-1-mediated inflammasome pathway may be involved in the host immune response to A. lentulus.