Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria
Background: Triazole resistance in Aspergillus spp. has therapeutic implications for managing chronic pulmonary aspergillosis (CPA) worldwide. However, antifungal susceptibility testing (AFST) is not routinely performed in Nigeria, a country with a high CPA burden. Objective: This study aimed to co...
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AOSIS
2025-07-01
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| Series: | African Journal of Laboratory Medicine |
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| author | Adeyinka A. Davies Bram Spruijtenburg Eelco F.J. Meijer Iriagbonse I. Osaigbovo Oluwaseyi Balogun Abiola Adekoya Titilola Gbaja-Biamila Jacques F. Meis Rita Oladele |
| author_facet | Adeyinka A. Davies Bram Spruijtenburg Eelco F.J. Meijer Iriagbonse I. Osaigbovo Oluwaseyi Balogun Abiola Adekoya Titilola Gbaja-Biamila Jacques F. Meis Rita Oladele |
| author_sort | Adeyinka A. Davies |
| collection | DOAJ |
| description | Background: Triazole resistance in Aspergillus spp. has therapeutic implications for managing chronic pulmonary aspergillosis (CPA) worldwide. However, antifungal susceptibility testing (AFST) is not routinely performed in Nigeria, a country with a high CPA burden.
Objective: This study aimed to confirm the identity of Aspergillus spp. isolated from patients with CPA using molecular methods, determine their antifungal susceptibility profile, and ascertain phylogenetic relatedness.
Methods: This study examined 47 Aspergillus isolates from sputum samples obtained in a prospective longitudinal study of CPA prevalence among 141 consenting symptomatic tuberculosis patients in Lagos, Nigeria, between June 2021 and May 2022. The preliminary phenotypically identified Aspergillus spp. were further identified by amplifying the calmodulin gene and performing AFST against seven antifungal agents using the Clinical Laboratory Standard Institute (CLSI) micro-dilution method, as well as determining their phylogenetic relatedness.
Results: The 51 patients who met the diagnostic criteria for CPA included 30 (59.0%) male and 21 (41.0%) female patients (age range: 17–68 years). Thirty-six (71.0%) had positive Aspergillus cultures. An isolate, initially identified phenotypically as A. fumigatus, was reidentified as A. pseudonomiae. Phylogenetic analysis on A. fumigatus and A. flavus isolates suggested the absence of clonal transmission. All isolates were susceptible to the tested antifungals.
Conclusion: Clinical Aspergillus isolates from azole-naïve patients with CPA did not demonstrate triazole resistance. Nonetheless, AFST is required for patients on long-term azole therapy and systematic surveillance of clinical and environmental isolates is recommended to detect the emergence of azole-resistant phenotypes.
What this study adds: This study underscores the importance of routine surveillance for antifungal resistance to detect the occurrence of resistance strains early in clinical settings, as this has therapeutic implications for patients harbouring resistant phenotypes. |
| format | Article |
| id | doaj-art-bcab4bc3ba81438f90db5385e0708b23 |
| institution | Matheson Library |
| issn | 2225-2002 2225-2010 |
| language | English |
| publishDate | 2025-07-01 |
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| series | African Journal of Laboratory Medicine |
| spelling | doaj-art-bcab4bc3ba81438f90db5385e0708b232025-08-04T09:04:35ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102025-07-01141e1e810.4102/ajlm.v14i1.2674508Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in NigeriaAdeyinka A. Davies0Bram Spruijtenburg1Eelco F.J. Meijer2Iriagbonse I. Osaigbovo3Oluwaseyi Balogun4Abiola Adekoya5Titilola Gbaja-Biamila6Jacques F. Meis7Rita Oladele8Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University Teaching Hospital, SagamuDepartment of Medical Microbiology and Immunology, Canisius-Wilhelmina Hospital (CWZ)/Dicoon, Nijmegen, the Netherlands; and, Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, theDepartment of Medical Microbiology and Immunology, Canisius-Wilhelmina Hospital (CWZ)/Dicoon, Nijmegen, the Netherlands; and, Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, theDepartment of Medical Microbiology, School of Medicine, University of Benin, Benin CityDepartment of Biomedical Engineering, University of Lagos, Idi-Araba, SurulereDepartment of Radiology, Olabisi Onabanjo University Teaching Hospital, SagamuNigeria Institute of Medical Research, Yaba, Lagos, Nigeria; and, Saint Louis University College of Public Health and Social Justice, St. Louis, Missouri,Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, the Netherlands; and, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) and Excellence center for Medical Mycology, University of Cologne, CologneDepartment of Medical Microbiology and Parasitology, Lagos University Teaching Hospital, Idi-Araba, LagosBackground: Triazole resistance in Aspergillus spp. has therapeutic implications for managing chronic pulmonary aspergillosis (CPA) worldwide. However, antifungal susceptibility testing (AFST) is not routinely performed in Nigeria, a country with a high CPA burden. Objective: This study aimed to confirm the identity of Aspergillus spp. isolated from patients with CPA using molecular methods, determine their antifungal susceptibility profile, and ascertain phylogenetic relatedness. Methods: This study examined 47 Aspergillus isolates from sputum samples obtained in a prospective longitudinal study of CPA prevalence among 141 consenting symptomatic tuberculosis patients in Lagos, Nigeria, between June 2021 and May 2022. The preliminary phenotypically identified Aspergillus spp. were further identified by amplifying the calmodulin gene and performing AFST against seven antifungal agents using the Clinical Laboratory Standard Institute (CLSI) micro-dilution method, as well as determining their phylogenetic relatedness. Results: The 51 patients who met the diagnostic criteria for CPA included 30 (59.0%) male and 21 (41.0%) female patients (age range: 17–68 years). Thirty-six (71.0%) had positive Aspergillus cultures. An isolate, initially identified phenotypically as A. fumigatus, was reidentified as A. pseudonomiae. Phylogenetic analysis on A. fumigatus and A. flavus isolates suggested the absence of clonal transmission. All isolates were susceptible to the tested antifungals. Conclusion: Clinical Aspergillus isolates from azole-naïve patients with CPA did not demonstrate triazole resistance. Nonetheless, AFST is required for patients on long-term azole therapy and systematic surveillance of clinical and environmental isolates is recommended to detect the emergence of azole-resistant phenotypes. What this study adds: This study underscores the importance of routine surveillance for antifungal resistance to detect the occurrence of resistance strains early in clinical settings, as this has therapeutic implications for patients harbouring resistant phenotypes.https://ajlmonline.org/index.php/ajlm/article/view/2674chronic pulmonary aspergillosisantifungal susceptibility testphylogenetic analysistuberculosisaspergillus spp.nigeria. |
| spellingShingle | Adeyinka A. Davies Bram Spruijtenburg Eelco F.J. Meijer Iriagbonse I. Osaigbovo Oluwaseyi Balogun Abiola Adekoya Titilola Gbaja-Biamila Jacques F. Meis Rita Oladele Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria African Journal of Laboratory Medicine chronic pulmonary aspergillosis antifungal susceptibility test phylogenetic analysis tuberculosis aspergillus spp. nigeria. |
| title | Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria |
| title_full | Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria |
| title_fullStr | Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria |
| title_full_unstemmed | Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria |
| title_short | Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria |
| title_sort | molecular identification and antifungal susceptibility testing of aspergillus species among patients with chronic pulmonary aspergillosis in nigeria |
| topic | chronic pulmonary aspergillosis antifungal susceptibility test phylogenetic analysis tuberculosis aspergillus spp. nigeria. |
| url | https://ajlmonline.org/index.php/ajlm/article/view/2674 |
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