Find in Library

Cryptic species of <i>Aspergillus</i> have rapidly increased in the last few decades. Chronic pulmonary aspergillosis (CPA) is a debilitating fungal infection frequently affecting patients with previous TB. The identification and antifungal susceptibility profiles of different species of <i>Aspergillus</i> are important to support the management of CPA. The aim of this study was to describe the molecular and susceptibility profiles of <i>Aspergillus</i> isolated from CPA patients. The species identity of isolates was determined by combined DNA analyses of internal transcribed space (ITS), partial β-tubulin genes, and part of the calmodulin gene. We revealed a high (27%) prevalence of cryptic species among previous tuberculosis patients with persistent symptoms. Twenty-nine (49%) patients met the criteria for diagnosis of CPA with 24% containing <i>Aspergillus</i> cryptic species. This is the first report of five cryptic <i>Aspergillus</i> species from clinical isolates in Indonesia: <i>A. aculea tus</i>, <i>A. neoniger</i>, <i>A. brunneoviolacues</i>, <i>A. welwitschiae,</i> and <i>A. tubingensis</i>. Significantly, there was decreased sensitivity against itraconazole in the CPA group (66% susceptible to itraconazole) compared to the non-CPA group (90% susceptible to itraconazole) (<i>p</i> = 0.003). The species-level characterisation of <i>Aspergillus</i> and its antifungal susceptibility tests demands greater attention to better the management of CPA patients.