Klinik Örneklerden İzole edilen Aspergillus Türlerinin Tanısal Önemi

Abstract

Aspergilloz, kapalı alanlarda və çevrede bulunan Aspergillus mantarı ile oluşan enfeksiyondur. İmmune sistemi baskılanmış kişilerde ve altta yatan akciğer hastalıkları olan hastalarda Aspergillus sporları çeşitli patolojik durumlara neden olabilir. Her yıl 200000 yeni invaziv aspergilloz (IA) vakası kayıt edilmektedir. Kronik obstrüktif akciğer hastalığı (KOAH) olan hastalarında IA'ya bağlı mortalite %72-95 arasında değişmektedir. 3 milyon insan farklı kronik pulmoner aspergilloz (KPA) formları ile hastadır. Araştırmanın amacı, Aspergillus türlerinin görülme sıklığını ve klinik örneklerde tanısal önemini belirlemektir.Ağustos 2017'den Ağustos 2018'e kadar olan periyotda 1170 hastanın örneği Aspergillus spp'in tespiti için incelenmiştir. Toplanan örnekler, kloramfenikollü Sabouraud dekstroz agarına inoküle edildi ve 10 gün boyunca 37°C'de inkübe edildi. Küf kolonilerinin üremesi durumunda, makroskobik ve mikroskobik özelliklere dayalı ileri tanımlama yapılmıştır. 22 hastada (1.88%) Aspergillus spp. kolonisinin ürediği tespit edildi. Onlardan 16'sı erkek, 6'sı kadındı. 7 hastada KOAH, 7 hastada bronşiyal astım (BA), 4 hastada akciğer tüberkulozu (AT), 1 hastada akut solunum yetmezliği, 1 hastada bronşektazi, 1 hastada eksüdatif plörezi, 1 hastada da akut lösemi vardı. Dört farkı Aspergillus türü izole edildi: A. niger, A. fumigatus, A. flavus ve A. terreus. A. niger genellikle BA ile ilişkiliyken, KOAH ve AT hastalarında A. fumigatus hakimdi. KOAH ve AT'lu hastalarda aspergilloz riskinin uygun tedavi sağlamak için ve mortalite oranlarını azaltmak maksadıyla dikkate alınması gerektiğini düşünüyoruz.

Keywords

• Aspergillus spp.,invaziv aspergilloz,kronik pulmoner aspergilloz,kronik obstrüktif akciğer hastalığı,akciğer tüberkulozu

Diagnostic Significance of Aspergillus Species Isolated from Clinical Specimens

Abstract

Aspergillosis is an infection caused by Aspergillus, ubiquitous mold found in indoor and outdoor air. In patients with immune suppression and underlying lung diseases Aspergillus spores are able to cause various pathologic conditions. Annually 200000 new cases of invasive aspergillosis (IA) are registered. Mortality due to IA in chronic obstructive pulmonary diseases (COPD) patients varies within 72-95%. 3 million people suffer from different forms of chronic pulmonary aspergillosis (CPA). The aim of the investigation was to determine the incidence of Aspergillus species and their diagnostic significance in clinical samples. Specimens of 1170 patients were investigated for the presence of Aspergillus spp. for period from august 2017 to august 2018. The collected specimens were inoculated onto Sabouraud dextrose agar with chloramphenicol and incubated at 37 ˚С temperature for 10 days. In case of growth of mold colonies, further identification was performed based on macroscopic and microscopic features. Growth of Aspergillus spp. colonies were detected in 22 patients (1.88%). 16 of them were males, 6 – females. 7 patients had COPD, 7- bronchial asthma (BA), 4 – pulmonary tuberculosis (PT), 1 – acute respiratory insufficiency, 1 – bronchiectatic disease, 1 – exudative pleurisy and 1 – acute leucosis. Four different species were isolated: Aspergillus niger, A. fumigatus, A. flavus, and A. terreus. A. niger commonly was associated with BA, while in patients with COPD and PT prevailed A. fumigatus. We consider that in patients with COPD and PT risk of aspergillosis should be taken into account in order to provide them with appropriate treatment and reduce mortality rates

Keywords

• Aspergillus spp.,invasive aspergillosis,chronic pulmonary aspergillosis,chronic obstructive pulmonary disease,pulmonary tuberculosis

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