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• W3209507530 abstract "Asthma is a chronic pulmonary disease accompanied by inflammation and airways obstruction. The disease can cause respiratory problems for the patient. With regard to severity of being involved with the disease, the individual's need to inhaled and systemic corticosteroids is variable. With increasing severity of the disease and using more corticosteroid doses, conditions for resistant thermal filamentous fungi like Aspergillus species are favored. Inhalation of conidia or hyphae followed by the establishment of fungi in the lungs and colonization in an individual’s airways and in the case of lack of removing it by related and appropriate antifungal drugs, fungal species such as Aspergillus provides conditions for infection with (SAFS, ABPA and even invasive aspergillosis). Therefore in the present study, patients with asthma evaluated for fungal colonization with an emphasis on identification of Aspergillus species and its relevance that with clinical symptoms of these patients and also the effect of Azole drugs, Echinocandins and Amphotericin B on isolates were studied.MethodThis descriptive-analytical study was done on sputum of asthma patients during 2015-2016 in Sari (Imam) and Tehran (Masih Daneshvari) Hospitals. The type of isolated Aspergillus was identified at species level by molecular methods. Then susceptibility to nine antifungal, azoles drugs including luliconazole (LUL), itraconazole (ITC), voriconazole (VRC), posaconazole (POS), ravuconazole (RAV) and Echinocandins including caspofungin (CAS), micafungin (MFG) and anidulafungin (AFG) and amphotericin B (AMB) were evaluated according to CLSI-M38-A2 protocol. Also Geometric mean، MIC/MEC 90، MIC/MEC50، MIC/MEC range were measured.Result131 isolates Of 137 Aspergillus spp. isolates, diagnosed at the species level by using molecular method. In total, 27 (90%), 65(48.1%) and 45 (88.2%) of Aspergillus spp. isolates were isolated from sputum culture of patients with mild, moderate and severe asthma respectively. Among Aspergillus spp. isolates, A. flavus (29.2%, 40/137) was the most prevalent species followed by A. fumigatus (27.7%, 38/137), A. niger and A. tubingensis by equal prevalence of (11.7%, 16/137). The range of fungi isolated from the asthmatic patients was (1-4) colonies with mean (2.3) colonies.Of the 30 healthy controls, 11 cases (36.7%) were positive in terms of fungal colonization.In total, of this 11 positive fungal culture, 11 isolates of fungi were isolated, that 9 isolates (81.8%) were related to Candida spp., 1 isolate (9.1%) of Cladosporium spp. and 1 isolate (9.1%) of Penicillium spp. Aspergillus species was not isolated from control group. In our study, statistically, there was no significant effect by species of Aspergillus on the respiratory volume parameters (FEV1, FVC) (P>0.05). Antifungal susceptibility testing was performed for 137 isolates by nine antifungal drugs. According to the results of the Geometric mean evaluation, the highest sensitivity was seen in anidulafungin 0.001418 μg/ml followed by micafungin 0.001745 μg/ml and luliconazole 0.002813 μg/ml. In the drug resistance evaluation for Aspergillus spp. isolates, antifungal resistance was reported in (3.6%) of isolated of fungi, totally. Among the 137 Aspergillus spp isolates, resistance was seen only in A. tubingensis. Among of 16 issolates of A. tubingensis, (18.7%) and (12.5%) of isolates were resistance to itraconazole and posaconazole respectively. Also, itraconazole and posaconazole cross resistantacne was reported in A. tubingensis in (12.5%) of cases. Out of 40 A. flavus isolates, 12.5% were semi-sensitive to voriconazole. Of 38 isolates of A. fumigatus, (5.3%) and (2.6%) of isolates were semi-sensitive to itraconazole and voriconazole, respectively.DiscussionThe results of this study revealed, the dominant species from sputum samples of Iranian asthmatic patient were A. flavus, followed by A. fumigatus. Also, the isolated Aspergillus species from sputum culture of asthmatic patients showed acceptable sensitivity to antifungal drugs. Anidulafungin, micafungin and luliconazole were more effective than other antifungal drugs.Keywords: Asthma, Aspergillus colonisation, Fungi, Aspergillus flavus, Aspergillus fumigatus" @default.
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• W3209507530 date "2019-01-11" @default.
• W3209507530 modified "2023-09-23" @default.
• W3209507530 title "Evaluation of pulmonary fungal colonization of asthmatic patients with an emphasis on Aspergillus species identification" @default.
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