Fungal colonization in patients with chronic respiratory diseases

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Fungal colonization in patients with chronic respiratory diseases from Himalayan

region of India

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We screened patients with chronic respiratory diseases for microbiological and

serological evidences of fungal colonisation; in order to determine its

prevalence in this group of patients, examine potential clinical and

radiological predictors of fungal colonisation and characterise fungal agents

associated with individual diseases.

Methods: BAL samples from 60 consecutive patients were subjected to microscopy

and culture for fungal agents. Serum samples were analysed for precipitin

antibodies to Aspergillus antigen and Candida cytoplasmic antigen.

Statistical significance in the difference of fungal recovery between patient

groups was determined using the Chi-square test.

Results: The major diagnostic groups included patients with bronchogenic

carcinoma (n=31) and tubercular sequelae (n=16). In all, 28 patients (46.7%)

were culture-positive, with Candida and Aspergillus being recovered from 14 and

13 patients respectively.

Twenty-one patients (35%) showed presence of precipitin antibodies. Patients

with bronchogenic carcinoma showed increased predilection for colonisation with

Aspergillus, while Candida was recovered more commonly in tubercular sequelae

(p=0.02).

There was no statistically significant association between culture-positivity

and specific risk factors/ radiological findings.

Conclusion: The point-prevalence of fungal colonization was almost 50%. The

combination of fungal culture and serology helped improve diagnostic

sensitivity.

An interesting predilection was observed for Aspergillus and Candida, to

preferentially infect patients with Bronchogenic carcinoma and Tubercular

sequelae respectively. In absence of specific predictors, the possibility of

fungal colonization needs to be explored actively in these patients.

Author: Debasis BiswasSonal AgarwalGirish SindhwaniJagdish Rawat

Credits/Source: ls of Clinical Microbiology and Antimicrobials 2010, 9:28