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Original Research
Molecular identification and antifungal susceptibility testing of Aspergillus species among patients with chronic pulmonary aspergillosis in Nigeria
Submitted: 29 October 2024 | Published: 11 July 2025
About the author(s)
Adeyinka A. Davies, Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University Teaching Hospital, Sagamu, NigeriaBram Spruijtenburg, Department of Medical Microbiology and Immunology, Canisius-Wilhelmina Hospital (CWZ)/Dicoon, Nijmegen, the Netherlands; and, Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, the, Netherlands
Eelco F.J. Meijer, Department of Medical Microbiology and Immunology, Canisius-Wilhelmina Hospital (CWZ)/Dicoon, Nijmegen, the Netherlands; and, Radboudumc-CWZ Center of Expertise for Mycology, Nijmegen, the, Netherlands
Iriagbonse I. Osaigbovo, Department of Medical Microbiology, School of Medicine, University of Benin, Benin City, Nigeria
Oluwaseyi Balogun, Department of Biomedical Engineering, University of Lagos, Idi-Araba, Surulere, Nigeria
Abiola Adekoya, Department of Radiology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
Titilola Gbaja-Biamila, Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria; and, Saint Louis University College of Public Health and Social Justice, St. Louis, Missouri,, United States
Jacques F. Meis, 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, Cologne, Germany
Rita Oladele, Department of Medical Microbiology and Parasitology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
Abstract
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.
Keywords
Sustainable Development Goal
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Crossref Citations
1. Molecular epidemiology and genetic diversity of Aspergillus species in Chronic Pulmonary Aspergillosis patients from South India
Bram Spruijtenburg, Payel Pramanik, Jacques F Meis, Theun de Groot, Eelco F J Meijer, Arghadip Samaddar
Medical Mycology vol: 63 issue: 12 year: 2025
doi: 10.1093/mmy/myaf114