Can bronchial secretion cultures identify the etiologic agent of COVID-19-associated pulmonary aspergillosis in ICU patients? Comparison with a species-specific Aspergillus PCR in serum

Med Mycol. 2022 Dec 29;61(1):myac094. doi: 10.1093/mmy/myac094.

Abstract

Aspergillus spp. isolated from non-BAL cultures of coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) patients may reflect colonization rather than infection. Sera (n = 181) from 49 adult ICU CAPA patients (24 probable and 25 possible CAPA) with bronchial secretions (BS) culture positive for Aspergillus spp. were collected and tested for Aspergillus DNA detection by species-specific real-time PCR. Overall, 30/49 (61%) patients were PCR positive. BS culture/serum PCR agreement was moderate (21/30; 70%). Based on serum PCR positive patients, all CAPAs were due to A. fumigatus (80%), A. flavus (10%), and A. terreus (10%). No A. niger/A. nidulans or mixed infections were found despite positive BS cultures.

Keywords: Aspergillus spp; COVID-19-associated pulmonary aspergillosis (CAPA); bronchial secretions; causative agent; serum PCR.

Plain language summary

Discordant results were observed between bronchial secretion cultures and species-specific serum PCR (30%) with A. fumigatus being by far the most common etiological agent of CAPA (80%). No A. niger/A. nidulans or mixed infections were found despite positive cultures.

MeSH terms

  • Animals
  • Aspergillus / genetics
  • COVID-19* / complications
  • Intensive Care Units
  • Pulmonary Aspergillosis* / complications
  • Pulmonary Aspergillosis* / diagnosis
  • Pulmonary Aspergillosis* / microbiology
  • Real-Time Polymerase Chain Reaction