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

Anna Rozaliyani; Rudyanto Sedono; Ridhawati Sjam; Mulyati Tugiran; Robiatul Adawiyah; Findra Setianingrum; Anwar Jusuf; Saleha Sungkar; Ferry Hagen; Jacques F Meis; Retno Wahyuningsih

doi:10.3855/jidc.13135

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

Anna Rozaliyani, Rudyanto Sedono, Ridhawati Sjam, Mulyati Tugiran, Robiatul Adawiyah, Findra Setianingrum, Anwar Jusuf, Saleha Sungkar, Ferry Hagen, Jacques F Meis, Retno Wahyuningsih

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

4 Citations (Scopus)

Abstract

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.

Original language	English
Pages (from-to)	1014-1020
Number of pages	7
Journal	Journal of infection in developing countries
Volume	15
Issue number	7
DOIs	https://doi.org/10.3855/jidc.13135
Publication status	Published - 31 Jul 2021

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10.3855/jidc.13135

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Rozaliyani, A., Sedono, R., Sjam, R., Tugiran, M., Adawiyah, R., Setianingrum, F., Jusuf, A., Sungkar, S., Hagen, F., Meis, J. F., & Wahyuningsih, R. (2021). Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia. Journal of infection in developing countries, 15(7), 1014-1020. https://doi.org/10.3855/jidc.13135

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

abstract = "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.",

author = "Anna Rozaliyani and Rudyanto Sedono and Ridhawati Sjam and Mulyati Tugiran and Robiatul Adawiyah and Findra Setianingrum and Anwar Jusuf and Saleha Sungkar and Ferry Hagen and Meis, {Jacques F} and Retno Wahyuningsih",

note = "Copyright (c) 2021 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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Rozaliyani, A, Sedono, R, Sjam, R, Tugiran, M, Adawiyah, R, Setianingrum, F, Jusuf, A, Sungkar, S, Hagen, F, Meis, JF & Wahyuningsih, R 2021, 'Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia', Journal of infection in developing countries, vol. 15, no. 7, pp. 1014-1020. https://doi.org/10.3855/jidc.13135

Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia. / Rozaliyani, Anna; Sedono, Rudyanto; Sjam, Ridhawati et al.
In: Journal of infection in developing countries, Vol. 15, No. 7, 31.07.2021, p. 1014-1020.

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

TY - JOUR

T1 - Molecular typing and antifungal susceptibility study of Aspergillus spp. in intensive care unit (ICU) patients in Indonesia

AU - Rozaliyani, Anna

AU - Sedono, Rudyanto

AU - Sjam, Ridhawati

AU - Tugiran, Mulyati

AU - Adawiyah, Robiatul

AU - Setianingrum, Findra

AU - Jusuf, Anwar

AU - Sungkar, Saleha

AU - Hagen, Ferry

AU - Meis, Jacques F

AU - Wahyuningsih, Retno

N1 - Copyright (c) 2021 Anna Rozaliyani, Rudyanto Sedono, Ridhawati Sjam, Mulyati Tugiran, Robiatul Adawiyah, Findra Setianingrum, Anwar Jusuf, Saleha Sungkar, Ferry Hagen, Jacques F Meis, Retno Wahyuningsih.

PY - 2021/7/31

Y1 - 2021/7/31

N2 - 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.

AB - 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.

U2 - 10.3855/jidc.13135

DO - 10.3855/jidc.13135

M3 - Article

C2 - 34343127

SN - 1972-2680

VL - 15

SP - 1014

EP - 1020

JO - Journal of infection in developing countries

JF - Journal of infection in developing countries

IS - 7

ER -

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

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