Aspergillosis caused by non-fumigatus Aspergillus species: risk factors and in vitro susceptibility compared with Aspergillus fumigatus

Diagn Microbiol Infect Dis. 2003 May;46(1):25-8. doi: 10.1016/s0732-8893(03)00013-0.

Abstract

Invasive aspergillosis (IA) caused by inherently more antifungal-resistant non-fumigatus Aspergillus species has become an important life-threatening complication in severely immunocompromised patients with cancer. The purpose of this study was to compare the relative incidence of, risk factors for, and in vitro correlation of amphotericin B and itraconazole with the clinical outcome of IA caused by Aspergillus fumigatus with those of IA caused by non-fumigatus Aspergillus spp. in patients with cancer. A retrospective search of our tertiary care cancer center's microbiology laboratory reports from 1998-2001 revealed 40 patients with cancer and IA. A non-fumigatus Aspergillus species caused IA in 28 (70%) of those patients. A. fumigatus was the predominant cause of late-onset IA after bone marrow transplantation (p = 0.05), whereas IA due to non-fumigatus Aspergillus spp. was more common in patients with neutropenia (p = 0.01). The minimum inhibitory concentration (50/90) and minimum fungicidal concentration (50/90) for amphotericin B were higher in the non-fumigatus Aspergillus spp. group than in the A. fumigatus one. The Aspergillus species distribution in IA cases in our institution shows a predominance of the more antifungal-resistant or -tolerant non-fumigatus Aspergillus spp.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Aspergillosis / diagnosis
  • Aspergillosis / drug therapy*
  • Aspergillosis / epidemiology*
  • Aspergillus / drug effects
  • Aspergillus / isolation & purification
  • Aspergillus fumigatus / drug effects*
  • Aspergillus fumigatus / isolation & purification
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Fungemia / diagnosis
  • Fungemia / drug therapy*
  • Fungemia / epidemiology*
  • Humans
  • Incidence
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Probability
  • Retrospective Studies
  • Risk Factors
  • Statistics, Nonparametric
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antifungal Agents