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Our group is recognised by the AGAUR (Project 2017SGR1432) the Catalan Health Agency. CG-V [FIS PI18/01061], PP-A[CM18/00132], EM-G [PI18/01061] and NG-P [FI19/00133] have received research grants from the Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, and the European RegionalDevelopment Fund. No funding body had any role in the studydesign, data collection and analysis, decision to publish, or preparation of the manuscript.

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Aspergillosis by cryptic Aspergillus species: A case series and review of the literature

Publicado en:Revista Iberoamericana De Micologia. 39 (2): 44-49 - 2022-06-01 39(2), DOI: 10.1016/j.riam.2022.04.002

Autores: Fernandez-Pittol, M; Alejo-Cancho, I; Rubio-García, E; Cardozo, C; Puerta-Alcalde, P; Moreno-García, E; Garcia-Pouton, N; Garrido, M; Villanueva, M; Alastruey-Izquierdo, A; Pitart, C; Garcia-Vidal, C; Marco, F

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Background: The cryptic Aspegillus species are rare, these microorganisms are usually more resistant to common antifungal therapies. Therefore, a correct identification is important when evaluating the impact of such species in aspergillosis. Aims: We aimed to describe the frequency, clinical and microbiological characteristics, and the outcomes of those cases of aspergillosis caused by cryptic species in a tertiary hospital. Methods: We retrospectively identified all microbiologically documented cases of aspergillosis between January 2013 and December 2018. Definitive species identification of clinically significant isolates was achieved via sequencing methods. The polymerase chain reaction (PCR) products were sequenced, and the results obtained were compared to sequences deposited in GenBank. Antifungal susceptibility testing was performed using the Sensititre® YeastOne® panel. Results: A total of 679 Aspergillus isolates were recovered from 489 patients, of which 109 were clinically relevant. Ten (9.2%) isolates were identified as cryptic species: Aspergillus arcoverdensis (2), Aspergillus lentulus (2), Aspergillus ellipticus (2), Aspergillus alliaceus (1), Aspergillus nomius (1), Aspergillus tubingensis (1) and Aspergillus montevidensis (1). Most patients already suffered some type of immunosuppression. Half of these patients had required intensive care before the infection showed up, and most of them had a pulmonary infection. Mortality at the 100-day follow-up was 40%. Antifungal susceptibility testing was performed on three of the isolates (A. arcoverdensis, A. tubingensis and A. nomius), which showed high minimum inhibitory concentrations (MIC) for azoles and amphotericin B. Conclusions: The frequency of cryptic species in our centre was 9.2%. Most patients had some degree of immunosuppression, and the mortality rate was 40%. © 2022 Asociación Española de Micología

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