Diagnostic Aspergillosis In The Sputum Of Patients With Pulmonary Complains And Antifungals Susceptibility Of Triazoles And Caspofungin Using E-Test

Abstract

Aspergillus infections are among the most feared opportunistic infections in humans because they are capable of causing several distinct pulmonary diseases .The aim of this study detection the aspergillosis occurrences with patients undergo pulmonary infection and Susceptibility testing of some antifungals by MIC and E-test . The results showed that 139 (44.6%) out of 311 patients were presented with pulmonary complain. of which yielded Aspergillus growth while 49 (15.7%) yielded no growth. Six patients (4.31%) were presented with tuberculosis. All of the patients have had a history of chronic bronchitis, pneumonia, cancer, suffering from Chronic Obstructive Pulmonary Disease (COPD) or have other form of pulmonary disease.Aspergillus isolates were obtained from two types of specimens, of which 47 isolates (33.8%) were obtained from Broncheoalveolar lavage (BAL) and the remaining 92 isolates (66.1%) were obtained from sputum.Aspergillus spp. were the predominant microorganism among the pathogenic fungi obtained by culture. 10 species of Aspergillus were identified, A.niger 71 (48.9%), A. flavus 71 (51%), A. fumigatus 16 (11.5%), A. terreus 40 (28.7%), A. oryzae 1 (0.71%), A. tumorous 4 (2.8%), A. candidus 9 (6.4%), A. tamari 3 (2.15%), A. parasiticus 3 (2.15%) and 1one isolate A. versicolor (2.15%).A. flavus, A. niger and A. terreus were the most frequent isolated species followed by A. fumigatus in the fourth place .Antibiotic susceptibility (MIC test) of 10 different Aspergillus isolates were performed using Epsilometer (E-test) technique. The following antifungal agents were used in the test: Caspofungin (CAS),Itraconazole (ITC), Posaconazole (POS) and Voriconazole (VO). The study results showed VO and CAS were having full inhibitory activity (100%) against the tested Aspergillus spp., while in case of ITC and POS some resistance were observed, (50% and 75% respectively).