Due to the diversity of ABPA manifestations and physicians' incomplete knowledge of the condition, patients with ABPA are often misdiagnosed and given poor prognosis. This study retrospectively analysed 75 patients diagnosed as ABPA in Zhongshan Hospital, Fudan University between October 2008 and June 2018. Nearly half of patients did not meet the diagnostic criteria of ABPA and all the patients who overlapped with invasive pulmonary aspergillosis (IPA) did not meet the diagnostic criteria of standard ABPA. Patients who did not fully meet the diagnostic criteria were more likely treated with inhaled corticosteroids (ICS) and antibiotics. This study demonstrates an unsatisfactory situation of diagnosis, treatment and prognosis of ABPA.
This case study of a A 64-year-old male with a history of stabile chronic obstructive pulmonary disease (COPD) describes an acute COPD exacerbation due to Aspergillus fumigatus that lead to an aberrant clinical profile unresponsive to conventional treatment. Clinicians should consider A.fumigatus as an etiologic agent in an atypical and severe COPD exacerbation.
Positive Aspergillus PCR as a marker of azole resistance or sub-therapeutic antifungal therapy in patients with chronic pulmonary aspergillosis (Moazam et al., 2020)
This study looked at CPA patients with a positive Aspergillus PCR, to determine whether a positive Aspergillus PCR is a marker of resistance in CPA patients on azole therapy. In treated patients, concurrent azole-resistant A. fumigatus was found in 75% of A fumigatus-positive cultures (6/8). Positive sputum, Aspergillus-specific PCR can be associated with azole resistance in CPA patients on therapy.
Section Flavi encompasses both harmful and beneﬁcial Aspergillus species, such as Aspergillus oryzae, used in food fermentation and enzyme production, and Aspergillus ﬂavus, food spoiler and mycotoxin producer. This paper reports the sequence of 19 genomes spanning section Flavi and compare 31 fungal genomes including 23 Flavi species. The paper includes genomic analyses, phenotypic assays, and identiﬁcation of secondary metabolites, highlights the genetic and metabolic diversity within section Flavi.
Respiratory mycobiome and suggestion of inter-kingdom network during acute pulmonary exacerbation in cystic fibrosis (Soret et al., 2020)
Lung infections play a critical role in cystic fibrosis (CF) pathogenesis. This paper characterises the microbiota and mycobiota of the CF respiratory tracts during CF pulmonary exacerbation (CFPE). The authors report finding three main clusters organized around Aspergillus, Candida, and Scedosporium genera, identifiying Aspergillus and Malassezia as relevantly associated with CFPE. They also report interactions between Aspergillus and Streptococcus and include documented mycobiome data into a version of the ecological Climax/Attack model that opens new lines of thoughts about the physiopathology of CF lung disease and future perspectives to improve its therapeutic management.