Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia

Introduction: Aspergillus exhibits a wide variation of susceptibility against antifungals according to genetic and environmental factors. Identification to the species level is necessary for appropriate treatment. Our objective was to determine the Aspergillus species involved in invasive pulmonary...

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Main Authors: Anna Rozaliyani, Rudyanto Sedono, Ridhawati Sjam, Mulyati Tugiran, Robiatul Adawiyah, Findra Setianingrum, Anwar Jusuf, Saleha Sungkar, Ferry Hagen, Jacques F Meis, Retno Wahyuningsih
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Language:English
Published: The Journal of Infection in Developing Countries 2021-07-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/13135
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author Anna Rozaliyani
Rudyanto Sedono
Ridhawati Sjam
Mulyati Tugiran
Robiatul Adawiyah
Findra Setianingrum
Anwar Jusuf
Saleha Sungkar
Ferry Hagen
Jacques F Meis
Retno Wahyuningsih
author_facet Anna Rozaliyani
Rudyanto Sedono
Ridhawati Sjam
Mulyati Tugiran
Robiatul Adawiyah
Findra Setianingrum
Anwar Jusuf
Saleha Sungkar
Ferry Hagen
Jacques F Meis
Retno Wahyuningsih
author_sort Anna Rozaliyani
collection DOAJ
description Introduction: Aspergillus exhibits a wide variation of susceptibility against antifungals according to genetic and environmental factors. Identification to the species level is necessary for appropriate treatment. Our objective was to determine the Aspergillus species involved in invasive pulmonary aspergillosis (IPA) among ICU patients in Jakarta, Indonesia. Methodology: The incidence of IPA in ICU patients at six hospitals in Jakarta from October 2012 – January 2015 was investigated. It involved a collection of endotracheal aspirates (ETA), nasal swabs and environmental samples around the hospitals, phenotypic screening, molecular characterization, and antifungal susceptibility testing. Results: Of the 405 patients investigated, 31 patients (7.7%) were diagnosed with putative IPA, from whom 45 Aspergillus isolates were collected. Aspergillus isolates were identified from pulmonary secretions in 24 patients, from nasal swabs in 7 patients and from both pulmonary secretions and nasal swabs in 7 patients. The phenotypic method showed 33 isolates of Aspergillus flavus (73.4%), nine Aspergillus fumigatus (20%), two Aspergillus niger (4.4%), and one Aspergillus nidulans (2.2%) isolate. Molecular identification showed 27 isolates of A. flavus (60.0%), eight isolates of A. fumigatus (17.8%), two isolates of A. niger (4.4%) and one isolate of A. nidulans (2.2%), while seven isolates (15.6%) were cryptic species or mixed isolates. Conclusions: Susceptibility testing showed all isolates were susceptible to amphotericin B, azoles and micafungin. Aspergillus flavus was the main causative organism in IPA cases in Jakarta, followed by A. fumigatus.
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spelling doaj-art-13945431241c43039695ea2bb4c302352025-08-20T02:57:52ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-07-01150710.3855/jidc.13135Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in IndonesiaAnna Rozaliyani0Rudyanto Sedono1Ridhawati Sjam2Mulyati Tugiran3Robiatul Adawiyah4Findra Setianingrum5Anwar Jusuf6Saleha Sungkar7Ferry Hagen8Jacques F Meis9Retno Wahyuningsih10Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Anesthesiology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia/Persahabatan Hospital, Jakarta, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDepartment of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The NetherlandsDepartment of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The NetherlandsDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia Introduction: Aspergillus exhibits a wide variation of susceptibility against antifungals according to genetic and environmental factors. Identification to the species level is necessary for appropriate treatment. Our objective was to determine the Aspergillus species involved in invasive pulmonary aspergillosis (IPA) among ICU patients in Jakarta, Indonesia. Methodology: The incidence of IPA in ICU patients at six hospitals in Jakarta from October 2012 – January 2015 was investigated. It involved a collection of endotracheal aspirates (ETA), nasal swabs and environmental samples around the hospitals, phenotypic screening, molecular characterization, and antifungal susceptibility testing. Results: Of the 405 patients investigated, 31 patients (7.7%) were diagnosed with putative IPA, from whom 45 Aspergillus isolates were collected. Aspergillus isolates were identified from pulmonary secretions in 24 patients, from nasal swabs in 7 patients and from both pulmonary secretions and nasal swabs in 7 patients. The phenotypic method showed 33 isolates of Aspergillus flavus (73.4%), nine Aspergillus fumigatus (20%), two Aspergillus niger (4.4%), and one Aspergillus nidulans (2.2%) isolate. Molecular identification showed 27 isolates of A. flavus (60.0%), eight isolates of A. fumigatus (17.8%), two isolates of A. niger (4.4%) and one isolate of A. nidulans (2.2%), while seven isolates (15.6%) were cryptic species or mixed isolates. Conclusions: Susceptibility testing showed all isolates were susceptible to amphotericin B, azoles and micafungin. Aspergillus flavus was the main causative organism in IPA cases in Jakarta, followed by A. fumigatus. https://jidc.org/index.php/journal/article/view/13135Aspergillusmolecular typingsusceptibility
spellingShingle Anna Rozaliyani
Rudyanto Sedono
Ridhawati Sjam
Mulyati Tugiran
Robiatul Adawiyah
Findra Setianingrum
Anwar Jusuf
Saleha Sungkar
Ferry Hagen
Jacques F Meis
Retno Wahyuningsih
Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia
Journal of Infection in Developing Countries
Aspergillus
molecular typing
susceptibility
title Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia
title_full Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia
title_fullStr Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia
title_full_unstemmed Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia
title_short Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia
title_sort molecular typing and antifungal susceptibility study of aspergillus spp in intensive care unit icu patients in indonesia
topic Aspergillus
molecular typing
susceptibility
url https://jidc.org/index.php/journal/article/view/13135
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