A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study)
Background: A significant complication among post-tuberculosis patients is chronic pulmonary aspergillosis (CPA), with prevalence and outcomes varying by region. This study aimed to explore the epidemiology, clinical characteristics, and microbiological profiles of 219 post-tuberculosis patients wit...
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2025-04-01
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| author | Anna Rozaliyani Findra Setianingrum Fathiyah Isbaniah Heidy Agustin Raden Rara Diah Handayani Rosamarlina Syahrir Siti Pratiekauri Robiatul Adawiyah Hesti Setiastuti Mohammad Nizam Erhamza Retno Ariza S. Soemarwoto Irvan Medison Deddy Herman Avissena Dutha Pratama Jatu Apridasari Jani Jane Soedarsono Soedarsono Tutik Kusmiati Mufidatun Hasanah Diah Adhyaksanti Winda Sofvina Ammar A. Hasyim Chris Kosmidis David W. Denning |
| author_facet | Anna Rozaliyani Findra Setianingrum Fathiyah Isbaniah Heidy Agustin Raden Rara Diah Handayani Rosamarlina Syahrir Siti Pratiekauri Robiatul Adawiyah Hesti Setiastuti Mohammad Nizam Erhamza Retno Ariza S. Soemarwoto Irvan Medison Deddy Herman Avissena Dutha Pratama Jatu Apridasari Jani Jane Soedarsono Soedarsono Tutik Kusmiati Mufidatun Hasanah Diah Adhyaksanti Winda Sofvina Ammar A. Hasyim Chris Kosmidis David W. Denning |
| author_sort | Anna Rozaliyani |
| collection | DOAJ |
| description | Background: A significant complication among post-tuberculosis patients is chronic pulmonary aspergillosis (CPA), with prevalence and outcomes varying by region. This study aimed to explore the epidemiology, clinical characteristics, and microbiological profiles of 219 post-tuberculosis patients with persistent respiratory symptoms and lung cavities in Indonesia. Methods: The patients were divided into CPA (<i>n</i> = 144) and non-CPA (<i>n</i> = 75) groups. This cross-sectional study diagnosed CPA in post-tuberculosis patients using ERS/ESCMID criteria, integrating clinical, radiological, and fungal assessments. Serological tests for <i>Aspergillus</i>-specific IgG were conducted using immunochromatographic (ICT) and ELISA on serum samples. Sputum specimens were used in parallel for fungal culture, and radiological evaluations (e.g., chest X-rays or CT scans) were performed to identify typical CPA features such as cavitation and fibrosis. Results: Persistent cough was significantly more common in CPA patients (83.3%, <i>p</i> = 0.015), highlighting its role as a clinical indicator for CPA. Radiological infiltrates were found in 165 patients (75.3%); critical diagnostic markers of CPA were cavitation and pericavitary fibrosis. <i>Aspergillus</i>-specific IgG testing demonstrated high diagnostic utility, with positivity rates of 69.4% for ICT and 63.2% for ELISA among CPA patients. Among those with infiltrates, a positive <i>Aspergillus</i> culture was not more common (<i>p</i> > 0.05), whereas <i>Aspergillus</i> IgG was more often raised (<i>p</i> = 0.037), as was a positive ICT (<i>p</i> = 0.021). Regional analysis revealed a higher CPA burden in Region 1 (75%) compared to Region 2 (56%, <i>p</i> = 0.003), with <i>Aspergillus fumigatus</i> and <i>Aspergillus niger</i> predominating in Region 1. Conclusions: These findings highlight the importance of comprehensive approaches and region-specific CPA management strategies in Indonesia. |
| format | Article |
| id | doaj-art-9ad9e1084a6a45d6b02da92d9b719cbf |
| institution | DOAJ |
| issn | 2309-608X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj-art-9ad9e1084a6a45d6b02da92d9b719cbf2025-08-20T03:14:39ZengMDPI AGJournal of Fungi2309-608X2025-04-0111532910.3390/jof11050329A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study)Anna Rozaliyani0Findra Setianingrum1Fathiyah Isbaniah2Heidy Agustin3Raden Rara Diah Handayani4Rosamarlina Syahrir5Siti Pratiekauri6Robiatul Adawiyah7Hesti Setiastuti8Mohammad Nizam Erhamza9Retno Ariza S. Soemarwoto10Irvan Medison11Deddy Herman12Avissena Dutha Pratama13Jatu Apridasari14Jani Jane15Soedarsono Soedarsono16Tutik Kusmiati17Mufidatun Hasanah18Diah Adhyaksanti19Winda Sofvina20Ammar A. Hasyim21Chris Kosmidis22David W. Denning23Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaThe Indonesian Society of Respirology (Perhimpunan Dokter Paru Indonesia), Jakarta 13340, IndonesiaThe Indonesian Society of Respirology (Perhimpunan Dokter Paru Indonesia), Jakarta 13340, IndonesiaDepartment of Pulmonology and Respiratory Medicine, Indonesia University Hospital, Depok 16425, IndonesiaDepartment of Pulmonology and Respiratory Medicine, Sulianti Saroso Infectious Disease Hospital, Jakarta 14340, IndonesiaSulianti Saroso Infectious Disease Hospital, Jakarta 14340, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaTangerang City General Hospital, Tangerang 15111, IndonesiaGrha Permata Ibu Hospital, Depok 16425, IndonesiaAbdul Moeloek General Hospital, Bandar Lampung 35112, IndonesiaDepartment of Pulmonology and Respiratory Medicine, RSUP Dr. M. Djamil, Padang 25129, IndonesiaMadina General Hospital, Bukittinggi 26117, IndonesiaKariadi General Hospital, Semarang 50244, IndonesiaMoewardi General Hospital, Solo 57126, IndonesiaSyaiful Anwar General Hospital, Malang 65112, IndonesiaDepartment of Pulmonology and Respiratory Medicine, Sulianti Saroso Infectious Disease Hospital, Jakarta 14340, IndonesiaDr. Soetomo General Hospital, Surabaya 60286, IndonesiaKanujoso General Hospital, Balikpapan 76115, IndonesiaBeriman General Hospital, Balikpapan 76113, IndonesiaPulmonary Mycosis Centre, Jakarta 10430, IndonesiaDepartment of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, IndonesiaManchester Academic Health Science Centre, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M23 9LT, UKManchester Academic Health Science Centre, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M23 9LT, UKBackground: A significant complication among post-tuberculosis patients is chronic pulmonary aspergillosis (CPA), with prevalence and outcomes varying by region. This study aimed to explore the epidemiology, clinical characteristics, and microbiological profiles of 219 post-tuberculosis patients with persistent respiratory symptoms and lung cavities in Indonesia. Methods: The patients were divided into CPA (<i>n</i> = 144) and non-CPA (<i>n</i> = 75) groups. This cross-sectional study diagnosed CPA in post-tuberculosis patients using ERS/ESCMID criteria, integrating clinical, radiological, and fungal assessments. Serological tests for <i>Aspergillus</i>-specific IgG were conducted using immunochromatographic (ICT) and ELISA on serum samples. Sputum specimens were used in parallel for fungal culture, and radiological evaluations (e.g., chest X-rays or CT scans) were performed to identify typical CPA features such as cavitation and fibrosis. Results: Persistent cough was significantly more common in CPA patients (83.3%, <i>p</i> = 0.015), highlighting its role as a clinical indicator for CPA. Radiological infiltrates were found in 165 patients (75.3%); critical diagnostic markers of CPA were cavitation and pericavitary fibrosis. <i>Aspergillus</i>-specific IgG testing demonstrated high diagnostic utility, with positivity rates of 69.4% for ICT and 63.2% for ELISA among CPA patients. Among those with infiltrates, a positive <i>Aspergillus</i> culture was not more common (<i>p</i> > 0.05), whereas <i>Aspergillus</i> IgG was more often raised (<i>p</i> = 0.037), as was a positive ICT (<i>p</i> = 0.021). Regional analysis revealed a higher CPA burden in Region 1 (75%) compared to Region 2 (56%, <i>p</i> = 0.003), with <i>Aspergillus fumigatus</i> and <i>Aspergillus niger</i> predominating in Region 1. Conclusions: These findings highlight the importance of comprehensive approaches and region-specific CPA management strategies in Indonesia.https://www.mdpi.com/2309-608X/11/5/329chronic pulmonary aspergillosispost-tuberculosisIgG antibodies |
| spellingShingle | Anna Rozaliyani Findra Setianingrum Fathiyah Isbaniah Heidy Agustin Raden Rara Diah Handayani Rosamarlina Syahrir Siti Pratiekauri Robiatul Adawiyah Hesti Setiastuti Mohammad Nizam Erhamza Retno Ariza S. Soemarwoto Irvan Medison Deddy Herman Avissena Dutha Pratama Jatu Apridasari Jani Jane Soedarsono Soedarsono Tutik Kusmiati Mufidatun Hasanah Diah Adhyaksanti Winda Sofvina Ammar A. Hasyim Chris Kosmidis David W. Denning A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study) Journal of Fungi chronic pulmonary aspergillosis post-tuberculosis IgG antibodies |
| title | A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study) |
| title_full | A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study) |
| title_fullStr | A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study) |
| title_full_unstemmed | A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study) |
| title_short | A Silent Threat in Post-Tuberculosis Patients: Chronic Pulmonary Aspergillosis Survey in Multiple Regions of Indonesia (I-CHROME Study) |
| title_sort | silent threat in post tuberculosis patients chronic pulmonary aspergillosis survey in multiple regions of indonesia i chrome study |
| topic | chronic pulmonary aspergillosis post-tuberculosis IgG antibodies |
| url | https://www.mdpi.com/2309-608X/11/5/329 |
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