Aspergillus colonization in patients with chronic obstructive pulmonary disease

Background and Purpose: Chronic obstructive pulmonary disease (COPD) has been recognized as a risk factor for invasive aspergillosis. Airway colonization by Aspergillus species is a common feature of chronic pulmonary diseases. Nowadays, the incidence of COPD has increased in critically ill patients. The aim of the present study was to isolate and identify Aspergillus colonies in the respiratory tract of COPD patients. Materials and Methods: This study was performed on ۵۰ COPD patients, who were aged above ۱۸ years, and were in intensive care units of three hospitals in Sari, Iran, for at least six days. All the samples obtained from sputum, bronchoalveolar lavage, and tracheal aspirates were cultured for fungi each week. According to the conventional techniques, Aspergillus isolates were initially based on growth and standard morphological characteristics. To confirm the identification of grown Aspergillus, the partial beta-tubulin gene was sequenced using specific primers. Results: A total of ۵۰ patients, who met our inclusion criteria, were enrolled in the study during ۲۰۱۲-۱۴. The results showed that ۲۷ (۵۴%) and ۲۳ (۴۶%) of the participants were male and female, respectively. The majority of the patients developed dyspnea followed by hemoptysis, chest pain, and high fever. Corticosteroids and broad-spectrum antibacterial agents were administered to ۷۵% and ۸۰% of the patients, respectively. Based on the conventional and molecular approaches, A. fumigatus (seven cases ۴۳.۷%), A. flavus (five cases ۳۱.۲%), A. niger (one case ۶.۲%), A. terreus (one case ۶.۲%), A. orezea (one case ۶.۲%), and A. tubingensis (one case ۶.۲%) were recovered. Conclusion: Recovery of Aspergillus species from the respiratory tract of COPD patients with pneumonia indicates two possibilities: either colonization or invasive aspergillosis

Keywords:

Aspergillus , Chronic Obstructive Pulmonary Disease , colonization , sequencing